FARRIS, Circuit Judge:
David Poe Wood, an inmate at the Nevada State Prison sued Vernon Housewright, then Director of the Nevada State Department of Prisons, and George Sumner, Warden of the Nevada State Prison, in the United States District Court for the District of Nevada seeking damages and in-junctive relief under 42 U.S.C. § 1983. Wood alleged that the defendants were liable for: 1) deliberate indifference by the prison staff to his medical needs, and 2) for denying him meaningful access to the courts in his effort to pursue this action. The district court ruled in favor of the defendants. We affirm.
FACTS
I. Medical Treatment
In early January, two months before he was admitted to the Nevada State Prison, Wood injured his shoulder in a jailhouse fight. A Las Vegas physician repaired the damage by inserting two pins in Wood’s shoulder. He also prescribed a sling to immobilize Wood’s arm and to prevent the pins from coming dislodged.
On March 11, 1983, the Nevada State Prison admitted Wood as a new inmate. Ignoring Wood’s protests, the prison guard admitting Wood confiscated the sling because 1) he believed it to be a security threat and 2) he did not have access to Wood’s medical file to prove its medical necessity. Sometime in the next few days Wood broke one of the pins in his shoulder and began to experience pain.
Wood immediately complained of his injury and saw the prison physician several days later. The doctor prescribed an anti-inflammatory and pain-killing medication and recommended Wood be referred to an outside orthopedic specialist. No further [1334]*1334action was taken, because Wood’s medical records were still not at the prison.
On March 30, 1983 Wood was moved back to Las Vegas for hearings in his criminal conviction. He returned to the prison on April 14, 1983 and that same day he complained to prison authorities about the pain in his shoulder. Two days later Wood wrote a letter to Warden Sumner and Vernon Housewright, requesting assistance in expediting medical treatment. On April 22, 1983 Wood saw the prison physician again. The doctor took additional x-rays, prescribed more medication and again referred Wood to an outside orthopedic specialist. Wood signed a medical release form at that time. Finally, on May 4, 1983, Wood saw the orthopedic specialist, who removed the floating pin.
II. Access to the Courts
In 1984 Wood started working on bringing this lawsuit pro se. At that time he was incarcerated in the administrative segregation unit of the prison and so had limited access to law books. Wood had to rely on inmate law clerks, who had only limited education and training, to obtain requested law books from the prison library. Until September 1985 when the prison library system was upgraded, the law clerks had little formal training. This system of inmate law clerks was supplemented by monthly visits of the library supervisor to each unit. Wood did successfully use this system to conduct legal research. In March 1986 satellite law libraries were put in the segregation units, but the library in Wood’s unit was located in a supply cabinet to which he had only limited access.
On October 22, 1984 Wood wrote letters to Sumner and Housewright complaining about his inability to obtain legal help. Wood subsequently made numerous other protests to Sumner, Housewright and other prison officials regarding the lack of legal assistance. Sumner responded to Wood’s complaints and directed his assistants to ensure that Wood received proper legal assistance. Wood continued to complain about his difficulty in conducting research until the eve of his trial.
ANALYSIS
I. The Eighth Amendment Claim
An inmate’s complaint of inadequate medical care amounts to a constitutional violation if the inmate alleges “acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs.” Estelle v. Gamble, 429 U.S. 97, 106, 97 S.Ct. 285, 292, 50 L.Ed.2d 251 (1976); Toussaint v. McCarthy, 801 F.2d 1080, 1111 (9th Cir.1986), cert. denied, 481 U.S. 1069, 107 S.Ct. 2462, 95 L.Ed.2d 871 (1987). In determining deliberate indifference, we scrutinize the particular facts and look for substantial indifference in the individual case, indicating more than mere negligence or isolated occurrences of neglect. Toussaint, 801 F.2d at 1111. Prison officials are deliberately indifferent to a prisoner’s serious medical needs when they “deny, delay or intentionally interfere with medical treatment.” Hutchinson v. United States, 838 F.2d 390, 394 (9th Cir.1988). We agree with the district court that, while the prison official’s treatment of Wood may have been negligent, it did not rise to the level of deliberate indifference.
Wood’s strongest claim is that the prison officials failed to provide the inmate’s medical records when he arrived at Nevada State Prison. This failure caused the confiscation of Wood’s sling, which in turn caused the harm Wood complains of. This conduct, though apparently inexcusable, does not amount to deliberate indifference. While poor medical treatment will at a certain point rise to the level of constitutional violation, mere malpractice, or even gross negligence, does not suffice. Although Wood’s treatment was not as prompt or efficient as a free citizen might hope to receive, Wood was given medical care at the prison that addressed his needs. Cf. Ortiz v. City of Imperial, 884 F.2d 1312 (9th Cir.1989) (deliberate indifference found where police knew of prisoner’s condition and totally failed to treat it competently).
[1335]*1335Nor does the delay in treatment that Wood suffered constitute an eighth amendment violation; the delay must have caused substantial harm. See Shapley v. Nevada Bd. of State Prison Com’rs, 766 F.2d 404, 407 (9th Cir.1985). Given the seriousness of his condition and the treatment Wood actually received such harm was not present here. Wood’s condition did not require emergency attention. Cf. Broughton v. Cutter Laboratories, 622 F.2d 458, 460 (9th Cir.1980) (delay of six days in treating hepatitis may constitute deliberate indifference). Nor did the delay substantially harm Wood’s treatment, considering that the only remedy immediately available was a prescription for painkillers. Cf. Hunt v. Dental Department, 865 F.2d 198, 199 (9th Cir.1989) (three month delay in replacing dentures, causing gum disease and possibly weight loss constituted eighth amendment violation).
II. The Sixth Amendment Claim
Bounds v. Smith, 430 U.S. 817, 828, 97 S.Ct.
Free access — add to your briefcase to read the full text and ask questions with AI
FARRIS, Circuit Judge:
David Poe Wood, an inmate at the Nevada State Prison sued Vernon Housewright, then Director of the Nevada State Department of Prisons, and George Sumner, Warden of the Nevada State Prison, in the United States District Court for the District of Nevada seeking damages and in-junctive relief under 42 U.S.C. § 1983. Wood alleged that the defendants were liable for: 1) deliberate indifference by the prison staff to his medical needs, and 2) for denying him meaningful access to the courts in his effort to pursue this action. The district court ruled in favor of the defendants. We affirm.
FACTS
I. Medical Treatment
In early January, two months before he was admitted to the Nevada State Prison, Wood injured his shoulder in a jailhouse fight. A Las Vegas physician repaired the damage by inserting two pins in Wood’s shoulder. He also prescribed a sling to immobilize Wood’s arm and to prevent the pins from coming dislodged.
On March 11, 1983, the Nevada State Prison admitted Wood as a new inmate. Ignoring Wood’s protests, the prison guard admitting Wood confiscated the sling because 1) he believed it to be a security threat and 2) he did not have access to Wood’s medical file to prove its medical necessity. Sometime in the next few days Wood broke one of the pins in his shoulder and began to experience pain.
Wood immediately complained of his injury and saw the prison physician several days later. The doctor prescribed an anti-inflammatory and pain-killing medication and recommended Wood be referred to an outside orthopedic specialist. No further [1334]*1334action was taken, because Wood’s medical records were still not at the prison.
On March 30, 1983 Wood was moved back to Las Vegas for hearings in his criminal conviction. He returned to the prison on April 14, 1983 and that same day he complained to prison authorities about the pain in his shoulder. Two days later Wood wrote a letter to Warden Sumner and Vernon Housewright, requesting assistance in expediting medical treatment. On April 22, 1983 Wood saw the prison physician again. The doctor took additional x-rays, prescribed more medication and again referred Wood to an outside orthopedic specialist. Wood signed a medical release form at that time. Finally, on May 4, 1983, Wood saw the orthopedic specialist, who removed the floating pin.
II. Access to the Courts
In 1984 Wood started working on bringing this lawsuit pro se. At that time he was incarcerated in the administrative segregation unit of the prison and so had limited access to law books. Wood had to rely on inmate law clerks, who had only limited education and training, to obtain requested law books from the prison library. Until September 1985 when the prison library system was upgraded, the law clerks had little formal training. This system of inmate law clerks was supplemented by monthly visits of the library supervisor to each unit. Wood did successfully use this system to conduct legal research. In March 1986 satellite law libraries were put in the segregation units, but the library in Wood’s unit was located in a supply cabinet to which he had only limited access.
On October 22, 1984 Wood wrote letters to Sumner and Housewright complaining about his inability to obtain legal help. Wood subsequently made numerous other protests to Sumner, Housewright and other prison officials regarding the lack of legal assistance. Sumner responded to Wood’s complaints and directed his assistants to ensure that Wood received proper legal assistance. Wood continued to complain about his difficulty in conducting research until the eve of his trial.
ANALYSIS
I. The Eighth Amendment Claim
An inmate’s complaint of inadequate medical care amounts to a constitutional violation if the inmate alleges “acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs.” Estelle v. Gamble, 429 U.S. 97, 106, 97 S.Ct. 285, 292, 50 L.Ed.2d 251 (1976); Toussaint v. McCarthy, 801 F.2d 1080, 1111 (9th Cir.1986), cert. denied, 481 U.S. 1069, 107 S.Ct. 2462, 95 L.Ed.2d 871 (1987). In determining deliberate indifference, we scrutinize the particular facts and look for substantial indifference in the individual case, indicating more than mere negligence or isolated occurrences of neglect. Toussaint, 801 F.2d at 1111. Prison officials are deliberately indifferent to a prisoner’s serious medical needs when they “deny, delay or intentionally interfere with medical treatment.” Hutchinson v. United States, 838 F.2d 390, 394 (9th Cir.1988). We agree with the district court that, while the prison official’s treatment of Wood may have been negligent, it did not rise to the level of deliberate indifference.
Wood’s strongest claim is that the prison officials failed to provide the inmate’s medical records when he arrived at Nevada State Prison. This failure caused the confiscation of Wood’s sling, which in turn caused the harm Wood complains of. This conduct, though apparently inexcusable, does not amount to deliberate indifference. While poor medical treatment will at a certain point rise to the level of constitutional violation, mere malpractice, or even gross negligence, does not suffice. Although Wood’s treatment was not as prompt or efficient as a free citizen might hope to receive, Wood was given medical care at the prison that addressed his needs. Cf. Ortiz v. City of Imperial, 884 F.2d 1312 (9th Cir.1989) (deliberate indifference found where police knew of prisoner’s condition and totally failed to treat it competently).
[1335]*1335Nor does the delay in treatment that Wood suffered constitute an eighth amendment violation; the delay must have caused substantial harm. See Shapley v. Nevada Bd. of State Prison Com’rs, 766 F.2d 404, 407 (9th Cir.1985). Given the seriousness of his condition and the treatment Wood actually received such harm was not present here. Wood’s condition did not require emergency attention. Cf. Broughton v. Cutter Laboratories, 622 F.2d 458, 460 (9th Cir.1980) (delay of six days in treating hepatitis may constitute deliberate indifference). Nor did the delay substantially harm Wood’s treatment, considering that the only remedy immediately available was a prescription for painkillers. Cf. Hunt v. Dental Department, 865 F.2d 198, 199 (9th Cir.1989) (three month delay in replacing dentures, causing gum disease and possibly weight loss constituted eighth amendment violation).
II. The Sixth Amendment Claim
Bounds v. Smith, 430 U.S. 817, 828, 97 S.Ct. 1491, 1498, 52 L.Ed.2d 72 (1977), established the right of inmates to “meaningful” access to the courts through “adequate law libraries or adequate assistance from persons trained in law.” In determining whether this constitutional minimum has been breached, we “focus on whether the individual plaintiff before [us] has been denied meaningful access.” King v. Atiyeh, 814 F.2d 565, 568 (9th Cir.1987) (citation omitted).
Our prior decisions support the district court’s finding that the system of satellite law libraries and inmate law clerks provided to Wood was constitutionally adequate. The system at the Nevada State Prison is very similar to the one we found constitutional in Lindquist v. Idaho State Bd. of Corrs., 776 F.2d 851 at 854 (9th Cir.1985) (library supplemented by inmate law clerks provides meaningful access to the courts). Although Wood’s access to the library was limited because of his special conditions of confinement, we have held that prison officials may regulate the use of the library to ensure the security of the facility. Id. at 858.
Wood himself admitted that he could and did get the books and supplies he needed to complete basic research, and that he received assistance from other inmates in preparing his legal materials. Wood’s success was naturally limited due to his lack of a legal education, but “[t]his circuit’s decisions have reflected our belief that the Constitution requires that certain minimum standards be met; it does not require the maximum or even the optimal level of ac-cess_ [T]he Constitution does not require the elimination of all economic, intellectual, and technological barriers to litigation.” Sands v. Lewis, 886 F.2d 1166, 1169 (9th Cir.1989).
Where inmates can not show denial of adequate law libraries or adequate assistance from persons trained in the law, they may still succeed by showing “actual injury” to court access. Id. at 1192 (confiscation of carbon paper and typewriter did not constitute actual injury). Again, Wood’s claim fails. Wood has not shown that defendants or their charges interfered in his efforts to bring this case. The only allegation of this type is that on one occasion prison guards took a book from Wood’s cell and returned it to the library so other inmates could use it. This action certainly did not constitute actual injury to Wood’s pursuit of his legal claim. The district court’s findings that Wood was not prejudiced in his efforts to seek redress for his legal claims is supported by the record.
III. Right to Counsel Claim
28 U.S.C. § 1915(d) provides that the district court may appoint counsel for indigent civil litigants. The district court refused to appoint counsel for Wood. That decision was not an abuse of discretion.
Counsel should only be appointed in exceptional circumstances, based on such factors as the likelihood of success on the merits and the ability of the plaintiff to articulate his claims in light of their complexity. Wilborn v. Escalderon, 789 F.2d 1328 at 1331 (9th Cir.1986). The instances that Wood claims indicate the presence of these factors are difficulties which any liti[1336]*1336gant would have in proceeding pro se; they do not indicate exceptional factors.
AFFIRMED.