Deborah Hager, Rick Bailey, and Harold Martin (together, “defendants”) appeal from a final order entered in the United States District Court for the Eastern District of Missouri upon a jury verdict in favor of Willie Robinson (“plaintiff’), finding that defendants were deliberately indifferent to plaintiffs serious medical needs in violation of the *562 Eighth Amendment. For reversal, defendants argue that the district court erred in denying their motion for judgment as a matter of law on plaintiffs Eighth Amendment claim because (1) plaintiff presented no evidence of causation and (2) plaintiff presented no evidence that defendants actually ignored or disregarded any request for help. For the reasons expressed below, we reverse.
Jurisdiction was proper in the district court pursuant to 28 U.S.C. § 1331. Defendant filed a timely notice of appeal, pursuant to Fed. R.App. P. 4(a)(1)(A). This court has jurisdiction pursuant to 28 U.S.C. § 1291.
I. Background
In May of 1995, plaintiff, a sixty-four-year-old man with a history of hypertension, was convicted in Jackson County Circuit Court of drug-related crimes and sentenced to a seven-year term of imprisonment. Plaintiffs sentence later was suspended, and plaintiff was required instead to enter a 120-day drug treatment program. Plaintiff was first sent to the Farmington Treatment Center, where Dr. Santiago Hallazgo assigned him to the chronic care clinic and prescribed enough hypertension medication to last thirty days. On June 9, 1995, plaintiff was transferred to the Mineral Area Treatment Center (MATC), where defendants were employed. Deborah Hager, as the Substance Abuse Supervisor, oversaw all operations at MATC, Sergeant Rick Bailey oversaw the custody staff, and Harold Martin was a custody officer. On arrival at MATC, plaintiffs hypertension medication was taken away from him, as per standard procedure.
Because MATC does not have its own medical department and has no doctors or nurses on its staff, inmates at MATC obtain all medical care from nearby Potosí Correctional Center (PCC), a maximum security penitentiary. An MATC-inmate cannot directly contact the PCC medical facility or obtain care on a walk-in basis. Rather, when an MATC inmate needs medical care, he is required to fill out a Medical Services Request form (“MSR”) and await notification of an appointment. An MATC inmate also may arrange for medical attention by asking MATC corrections staff to contact the PCC medical department on his behalf.
On June 19, 1995, plaintiff submitted an MSR for blood pressure medication to replace the supply that had been confiscated from him when he arrived at MATC. On June 21, 1995, Dr. Pedro Cayabyab from PCC prescribed enough medication to plaintiff to last thirty days. Plaintiff submitted another MSR to refill his prescription when the June 21 prescription began to run out. This time, plaintiff was not contacted about an appointment and did not receive a refill of his medication. Plaintiff filed additional MSRs, but still did not receive a response. According to plaintiff, he repeatedly complained to each of the defendants about the lack of response to his MSRs and his need for the medication. Plaintiff said that he complained to Bailey on three or four occasions, to Martin at least once, and to Hag-er at least twice. According to plaintiff, each of the defendants told plaintiff that they would contact the PCC medical staff on his behalf. 1 Plaintiff was never contacted by PCC medical staff and never received the medication. Plaintiff also said that he repeatedly requested to be excused *563 from the strenuous physical exercise required as part of the treatment program, but that these requests were rebuffed.
On August 20, 1995, nearly thirty days after plaintiffs June 21 prescription ran out, an MATC inmate reported to Martin that plaintiff had lost control of the right side of his body. At this point, Martin arranged for plaintiff to go to the PCC medical facility for observation and treatment. Plaintiff subsequently was transferred to a local- hospital for treatment. Plaintiffs medical records indicate that he had suffered a stroke.
Plaintiff sued defendants (as well as other corrections officers and members of the PCC medical staff) pursuant to 42 U.S.C. § 1983 asserting, inter alia, that defendants were deliberately indifferent to his serious medical needs. On August 24, 2000, the district court denied summary judgment as to defendants. The case proceeded to trial on March 5, 2001. On March 7, 2001, the district court denied defendants’ motions for judgment as a matter of law made at the close of plaintiffs case and at the close of all evidence.
On March 8, 2001, the jury returned a verdict in favor of plaintiff, finding that defendants were deliberately indifferent to plaintiffs serious medical needs in violation of the Eighth Amendment, and awarding him $5,000 in compensatory damages ($3,000 against Hager and $1,000 each against Martin and Bailey). 2 Defendants filed a post-trial motion for a new trial or judgment as a matter of law on March 22, 2001, which was denied on April 26, 2001. This appeal followed.
II. Discussion
This court reviews
de novo
a district court’s denial of a motion for judgment as a matter of law.
See Van Steenburgh v. Rival Co.,
The Eighth Amendment scrutinizes the conditions under which prison inmates are confined in order to prevent the inhumane treatment of inmates.
See Farmer v. Brennan,
We may assume without elaboration that a stroke is a serious medical harm, the risk of which was substantial in plaintiffs case. Viewing the evidence in the light most favorable to the verdict as required by
Van Steenburgh,
When an injury is sophisticated, proof of causation generally must be established by expert testimony.
See Turner v. Iowa Fire Equip. Co.,
Because plaintiff failed to offer any expert evidence showing that defendants’ actions caused him to suffer his stroke, we hold that plaintiff did not establish a pri-ma facie violation of the Eighth Amendment and that no reasonable juror could have found in favor of plaintiff. Hence, we hold that the district court erred in denying defendants’ motion for judgment as a matter of law on plaintiffs Eighth Amendment claim.
*565 III. Conclusion
For the reasons expressed above, we reverse the judgment of the district court.
Notes
. Each of the defendants testified that they had no specific recollection whether they had these conversations with plaintiffs, and neither confirmed nor denied that they took place.
. Following trial, plaintiff moved for $27,240 in attorney's fees pursuant to 42 U.S.C. § 1988 and challenged the cap on attorney's fees placed by the Prisoner Litigation Reform Act (PLRA). The district court ruled that the PLRA was constitutional, ordered defendants to pay plaintiff's attorneys $6,500 in fees, and ordered an additional $1,000 in fees to be paid by plaintiff out of the proceeds of the judgment. Plaintiff cross-appeals this ruling on the ground that the PLRA is unconstitutional. Because this circuit has already upheld the constitutionality of the PLRA, and because a panel cannot overturn another panel’s decision, no further consideration of this issiie is warranted.
See Foulk v. Charrier,
. Because we hold that there is insufficient evidence that plaintiffs lapse in hypertension medication caused his stroke, we do not reach the question of whether defendants knowingly disregarded plaintiffs risk of stroke by ignoring his repeated requests for the medication.