Troy R. Jackson v. Corizon Health, Inc. ( 2022 )


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  • USCA11 Case: 20-14737     Date Filed: 02/02/2022    Page: 1 of 19
    [DO NOT PUBLISH]
    In the
    United States Court of Appeals
    For the Eleventh Circuit
    ____________________
    No. 20-14737
    Non-Argument Calendar
    ____________________
    TROY R. JACKSON,
    Plaintiff-Appellant,
    versus
    CORIZON HEALTH, INC.,
    Defendant-Appellee.
    ____________________
    Appeal from the United States District Court
    for the Middle District of Florida
    D.C. Docket No. 3:18-cv-01041-MMH-JBT
    ____________________
    USCA11 Case: 20-14737       Date Filed: 02/02/2022     Page: 2 of 19
    2                      Opinion of the Court                20-14737
    Before BRANCH, LAGOA, and BRASHER, Circuit Judges.
    PER CURIAM:
    Troy Jackson, a pro se Florida prisoner, appeals the district
    court’s grant of summary judgment in favor of Corizon Health,
    Inc., on his claim of deliberate indifference to his medical needs
    and failure to train medical staff in violation of the Eighth
    Amendment, and the dismissal without prejudice of his related
    state law claims. Jackson argues that summary judgment was
    improper because there are genuine issues of material fact for a
    jury to decide regarding (1) the timeline of events; (2) whether
    Corizon had a policy of requiring staff to receive a doctor’s
    permission before transferring an inmate to an off-site hospital
    and avoiding hospital transfers in order to minimize medical care
    costs; and (3) whether Corizon had a policy of undertraining its
    staff. He also maintains that his state law claims should not have
    been dismissed. After review, we affirm.
    I.      Background
    Corizon Health, Inc. (“Corizon”) is a corporation that
    contracts with the Florida Department of Corrections to provide
    health care services in Florida’s prisons. Jackson, a Florida
    prisoner, filed a pro se 
    42 U.S.C. § 1983
     complaint against
    Corizon, asserting Eighth Amendment violations for deliberate
    indifference to his serious medical needs and a failure to train
    medical staff, as well as state law claims for intentional infliction
    USCA11 Case: 20-14737          Date Filed: 02/02/2022       Page: 3 of 19
    20-14737                 Opinion of the Court                            3
    of emotional distress, medical negligence, and negligent hiring,
    retention, or supervision.1 At the time of the events alleged in the
    complaint, Jackson was an inmate at Columbia Correctional
    Institute in Lake City, Florida. Jackson alleged that he suffers
    from chronic asthma and that, on June 27, 2015, at approximately
    3:00 a.m., he began suffering shortness of breath. He notified
    Sergeant Roebuck that he was having trouble breathing, and
    Sergeant Roebuck contacted the prison’s medical unit. Nurse
    Cynthia Lewis responded to the call and transported Jackson via
    wheelchair to the medical unit. Jackson’s oxygen level registered
    as 82%. Therefore, at 3:30 a.m., Nurse Lewis administered a
    nebulized breathing treatment and a Solumedrol injection.
    According to Jackson, approximately three minutes later,
    he went into respiratory failure and lost consciousness. At that
    time, Nurse Lewis panicked and exited the room without trying
    to revive Jackson. Officer Landig was on duty in the medical unit,
    and he ran after Lewis in an attempt to get her to return.
    Between 3:33 and 3:35 a.m., Officer Landig contacted the prison’s
    control room and advised of Jackson’s situation and that he
    needed immediate medical assistance. Jackson maintains that,
    during this time, Nurse Lewis was attempting to reach the
    physician on-call via phone, “presumably seeking instructions or
    permission to send [Jackson] to the outside Hospital Emergency
    1We refer to the allegations in Jackson’s second amended complaint which is
    the operative complaint in this case.
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    4                     Opinion of the Court               20-14737
    Room.”
    Sergeant Roebuck heard Officer Landig’s message over the
    radio, and immediately headed to the medical unit. Upon arrival,
    he questioned Nurse Lewis about whether she intended to
    administer CPR, and Nurse Lewis said “No.” Sergeant Roebuck
    began searching for an “Ambi-bag” and informed Nurse Lewis
    that Jackson would begin suffering brain damage if he was not
    revived.     Sergeant Roebuck located the Ambi-bag and
    administered CPR to Jackson, who began breathing.
    However, according to Jackson, at 4:08 a.m., he went into
    respiratory failure a second time, and once again Nurse Lewis
    refused to perform CPR, but Sergeant Roebuck administered
    CPR. At 4:13 a.m., Officer Landig called the control room and
    requested an ambulance. At some point during these events,
    Nurse Shiver entered the medical unit to assist.
    At 4:27 a.m., the ambulance arrived. Paramedics intubated
    Jackson, who remained unconscious, and the paramedics
    transported him to a local hospital. The local hospital later
    ordered Jackson to be transferred to a hospital in Jacksonville,
    Florida, where he was placed in intensive care for two days. He
    was diagnosed with “severe asthma exacerbation, post acute
    hypercapnic respiratory failure with ventilator support, and
    hypertension.” After his two-day stay in intensive care, the
    hospital discharged Jackson to North Florida Reception and
    Medical Center facility, where he stayed for a little over a week.
    Thereafter, he returned to Columbia Correctional Institute.
    Jackson alleged that, upon his return, he spoke with
    USCA11 Case: 20-14737        Date Filed: 02/02/2022      Page: 5 of 19
    20-14737                Opinion of the Court                         5
    Sergeant Roebuck, Officer Landig, and Nurse Lewis about the
    events surrounding his medical crisis, and they conveyed the facts
    to him that served as the basis for his complaint. Furthermore,
    Nurse Lewis explained that she did not perform CPR because her
    CPR certification had expired, and she did not want to be liable if
    something happened. She also explained that
    [she] did not immediately send [Jackson] to the
    emergency room when [he] went into respiratory
    failure, because we are instructed to find alternative
    treatment options that [are] cost efficient then to
    send an inmate to an outside hospital, and if there’s
    no other options available, to contact the on-call
    physician for approval to send an inmate to the
    hospital.
    Jackson alleged that, as a result of the staff’s inaction and the delay
    in treatment, he suffered a 50% reduction in his lung capacity and
    substantial memory loss.
    Accordingly, Jackson argued that Corizon was deliberately
    indifferent to his serious medical needs in violation of the Eighth
    Amendment because it had a custom, policy, or practice of
    requiring medical staff to receive permission from a physician
    before authorizing the transfer of an inmate to an off-site hospital
    even in emergency situations, and to seek alternative medical
    treatments in an effort minimize medical costs. He also alleged
    that Corizon failed to properly train Lewis. And he asserted
    several related state law claims for intentional infliction of
    emotional distress, medical negligence, and negligent hiring,
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    6                      Opinion of the Court                20-14737
    retention, or supervision.
    In support of his claims, Jackson submitted (1) copies of his
    administrative grievances concerning the medical care he
    received on June 27, 2015; (2) the paramedic’s prehospital care
    report; (3) Jackson’s sworn affidavit attesting that he spoke with
    Sergeant Roebuck and that Sergeant Roebuck informed Jackson
    “that he (Roebuck) had to perform cardiopulmonary resuscitation
    (“CPR”), because . . . [Nurse Lewis] refused to do so, because she
    had to telephonically contact the on-site physician to get
    permission to send [Jackson] out to a hospital emergency room”;
    (4) an October 2016 article discussing issues with Corizon health
    services in prison facilities across the country; and (5) opinions or
    orders from several other cases that had been brought against
    Corizon.
    Corizon moved for summary judgment, arguing that it had
    no policy limiting the authority of medical staff to make hospital
    transfers only to physicians or to avoid hospitalizations in order to
    save money.        Corizon noted that, after Jackson became
    unresponsive at 4:08 a.m., he was sent to the hospital by Nurse
    Shiver, not a physician. Furthermore, he received the necessary
    medical care—a breathing treatment, medication, CPR, and then
    hospital transportation—which Corizon argued negated his
    deliberate indifference claim. Corizon further argued that it could
    not be liable for failure to train because nothing in the record
    indicated a need for training or that Corizon was aware of any
    need for training. Finally, Corizon maintained that summary
    judgment was also appropriate on Jackson’s state law claims.
    USCA11 Case: 20-14737       Date Filed: 02/02/2022     Page: 7 of 19
    20-14737               Opinion of the Court                        7
    Jackson opposed the motion for summary judgment and
    submitted several exhibits in support of his claims. As relevant to
    this appeal, those exhibits included (1) the paramedic’s prehospital
    care report, which indicated that the paramedics received the
    emergency call at 4:14 a.m. on June 27, 2015, and they arrived at
    the prison at 4:27 a.m.; (2) the prison’s form for Jackson’s
    emergency transfer to an outside hospital, which was completed
    by Nurse Shiver, and indicated that (a) the time of event was 3:33
    a.m. and that Jackson’s condition upon arrival at medical was
    unstable, in respiratory distress, and unresponsive, and (b) the
    prison’s physician was contacted at 3:56 a.m., and (c) 911 was
    called at 4:13 a.m.; (3) various medical records; (4) complaints
    against Nurse Lewis and her disciplinary record; (5) Lewis’s
    training sheet documenting the topics Corizon provided training
    on and which trainings Lewis had completed; (6) Jackson’s sworn
    affidavit attesting that Nurse Lewis told him that the reason why
    she did not immediately send him to the hospital was because
    “we are instructed to find alternative treatment options that [are]
    cost efficient, then to send an inmate to an outside hospital, and if
    there’s no other options available[,] to contact the on call
    physician for approval to send an inmate to the hospital”; (7) a
    January 2015 sworn declaration from Dr. Charles Pugh (made as
    part of another case against Corizon), which addressed Dr. Pugh’s
    experience as Corizon’s Site Medical Director as a physician at the
    USCA11 Case: 20-14737             Date Filed: 02/02/2022         Page: 8 of 19
    8                          Opinion of the Court                       20-14737
    Chatham County Jail in Savannah, Georgia, in 2013 and 2014; 2
    and (8) Dr. Pugh’s 2016 deposition from yet another case brought
    against Corizon in Georgia based on the medical care an inmate
    received while in the Chatham County Jail.
    The district court granted Corizon’s motion for summary
    judgment as to the deliberate indifference and failure to train
    counts. The district court found that Corizon was entitled to
    summary judgment because the record confirmed that there was
    no policy or custom that allowed only physicians to authorize an
    inmate to be sent to a hospital. Rather, the record demonstrated
    that all medical staff could send inmates to hospitals for
    emergency care. With regard to Corizon’s alleged cost-cutting
    policy, the district court explained that Jackson’s reliance on
    Pugh’s declaration and deposition from other cases as evidence of
    this policy was misplaced because Pugh worked at a different
    prison and during a time period prior to the events in Jackson’s
    case. The district court also noted that nothing precludes prison
    officials from considering costs when determining what type or
    level of medical care an inmate should receive as long as such
    2
    Dr. Pugh stated that during his tenure, he was “required by Corizon to
    submit all physician consults and emergency room transfer requests to the
    Regional Medical Director,” and he “was constantly under pressure from
    [his] superiors in Corizon to minimize emergency room treatments . . . for
    jail inmates in order to save money.” He further asserted that “the
    company’s constant efforts to reduce costs interfered with [his] ability, and
    with the staff’s ability, to provide appropriate levels of care to inmates of the
    Chatham County Jail.”
    USCA11 Case: 20-14737       Date Filed: 02/02/2022    Page: 9 of 19
    20-14737               Opinion of the Court                       9
    considerations do not deprive the inmate of minimally adequate
    medical care, which the record demonstrated Jackson received.
    Accordingly, because Jackson failed to provide any evidence that
    tended to demonstrate that Corizon had a custom, policy, or
    practice that only physicians could order hospital transfers or that
    such transfers are discouraged because of costs, Corizon was
    entitled to summary judgment on Jackson’s deliberate
    indifference claim.
    Similarly, the district court determined that Corizon was
    entitled to summary judgment on Jackson’s failure to train claim
    because Jackson failed to present any evidence that Corizon had a
    policy not to train its staff or knew that there was a need to train
    its employees on how to initiate emergency inmate transfers to
    hospitals. Rather, the evidence established that Corizon had such
    training available, and the fact that Nurse Lewis may not have
    completed the training did not render Corizon liable. Finally,
    because all of Jackson’s federal claims were due to be dismissed,
    the district court declined to exercise supplemental jurisdiction
    over Jackson’s state law claims and dismissed those claims
    without prejudice. Jackson, proceeding pro se, appealed.
    II.      Discussion
    We review the grant of summary judgment de novo,
    viewing the record and drawing all reasonable inferences in favor
    of the nonmoving party “to the extent supportable by the
    record.” Garczynski v. Bradshaw, 
    573 F.3d 1158
    , 1165 (11th Cir.
    2009) (emphasis and quotation omitted). Summary judgment is
    USCA11 Case: 20-14737      Date Filed: 02/02/2022     Page: 10 of 19
    10                     Opinion of the Court               20-14737
    appropriate if “the movant shows that there is no genuine dispute
    as to any material fact and the movant is entitled to judgment as a
    matter of law.” Fed. R. Civ. P. 56(a). “A genuine issue of material
    fact exists when the evidence is such that a reasonable jury could
    return a verdict for the non-moving party.” Quigg v. Thomas
    Cnty. Sch. Dist., 
    814 F.3d 1227
    , 1235 (11th Cir. 2016) (alteration
    adopted) (quotation omitted). “Once the movant submits a
    properly supported motion for summary judgment, the burden
    shifts to the nonmoving party to show that specific facts exist that
    raise a genuine issue for trial. If the nonmoving party presents
    evidence that is merely colorable or not significantly probative,
    summary judgment is appropriate.” Boyle v. City of Pell City,
    
    866 F.3d 1280
    , 1288 (11th Cir. 2017) (quotations and internal
    citations omitted). “We may affirm for any reason supported by
    the record, even if not relied upon by the district court.” Hill v.
    Emp. Benefits Admin. Comm. of Mueller Grp. LLC, 
    971 F.3d 1321
    , 1325 (11th Cir. 2020).
    A. Medical Care Claim
    Jackson argues that the district court erred in entering
    summary judgment in favor of Corizon on his deliberate
    indifference to his serious medical needs claim because there are
    genuine issues of material fact regarding whether Corizon had a
    custom, policy, or practice of requiring staff to receive physician
    permission before transferring an inmate to a hospital and to
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    20-14737                 Opinion of the Court                           11
    avoid sending inmates to a hospital as a way of cutting costs.3 He
    maintains that there is a genuine issue of material fact concerning
    the existence of this policy based on (1) the fact that a physician
    was called on the night in question before Jackson was transferred
    to the emergency room; (2) Nurse Lewis’s statement to him that
    she was instructed to contact a physician for approval to send an
    inmate to an outside hospital; (3) Dr. Pugh’s statements that he
    was under pressure to minimize medical costs and to avoid
    sending prisoners to the hospital while a physician at the
    Chatham County Jail; and (4) the existence of other cases brought
    against Corizon based on similar allegations. We disagree.
    The Eighth Amendment prohibits “cruel and unusual
    punishments.” U.S. Const. amend. VIII. The Supreme Court has
    held that “deliberate indifference to serious medical needs of
    prisoners” constitutes cruel and unusual punishment. See Estelle
    v. Gamble, 
    429 U.S. 97
    , 104 (1976). As a result, the Constitution
    requires governments “to provide minimally adequate medical
    care to those whom they are punishing by incarceration.” Hoffer
    v. Fla. Dep’t of Corr., 
    973 F.3d 1263
    , 1270 (11th Cir. 2020)
    (quoting Harris v. Thigpen, 
    941 F.2d 1495
    , 1504 (11th Cir. 1991)).
    Thus, Jackson had to “show: (1) a serious medical need; (2) the
    3 Jackson also argues that there is a genuine issue of fact regarding the
    timeline of events and whether he went into respiratory failure once (as
    Corizon alleges) or twice (as he alleges). For purposes of this opinion, we
    accept as true Jackson’s timeline of events and the allegation that he went
    into respiratory failure twice.
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    12                     Opinion of the Court                 20-14737
    defendants’ deliberate indifference to that need; and (3) causation
    between that indifference and the plaintiff’s injury.” Craig v.
    Floyd Cnty., 
    643 F.3d 1306
    , 1310 (11th Cir. 2011) (quotation
    omitted).
    Private entities, like Corizon, may be liable under § 1983
    when they “perform[] a function traditionally within the exclusive
    prerogative of the state” such as providing medical services to
    persons to inmates. Id. (quotation omitted). Liability under
    § 1983 cannot be based on the theory of vicarious liability. Id.
    Thus, to prevail on his deliberate indifference claim against
    Corizon, Jackson had to prove that Corizon “had a ‘policy or
    custom’ of deliberate indifference that led to the violation of his
    constitutional right.” Id.
    “A policy is a decision that is officially adopted by the
    [entity], or created by an official of such rank that he or she could
    be said to be acting on behalf of the [entity].” Sewell v. Town of
    Lake Hamilton, 
    117 F.3d 488
    , 489 (11th Cir. 1997). And “[a]
    custom is a practice that is so settled and permanent that it takes
    on the force of law.” Id.; see also Craig, 
    643 F.3d at 1310
     (“An act
    performed pursuant to a ‘custom’ that has not been formally
    approved by an appropriate decisionmaker may fairly subject a[n]
    [entity] to liability on the theory that the relevant practice is so
    widespread as to have the force of law.” (alteration adopted)
    (quotation omitted)).
    Proof of a single incident of unconstitutional activity is not
    sufficient to demonstrate a policy or custom for purposes of
    § 1983 liability. Craig, 
    643 F.3d at 1310
    . Rather, a plaintiff must
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    20-14737               Opinion of the Court                        13
    establish the existence of a pattern of similar violations. 
    Id.
     “In
    the absence of a series of constitutional violations from which
    deliberate indifference can be inferred, the plaintiff must show
    that the policy itself is unconstitutional.” 
    Id. at 1311
     (alteration
    adopted) (quotation omitted).
    In sum, to survive summary judgment, Jackson had to
    produce evidence sufficient to create a genuine dispute of
    material fact on each element of liability under § 1983: (1) that
    Jackson’s constitutional rights were violated; (2) that Corizon had
    a custom or policy that constituted deliberate indifference to that
    constitutional right; and (3) that this policy caused the
    constitutional violation. See id. at 1310.
    As explained further in this opinion, Jackson’s claim fails
    because he failed to plead sufficient facts to establish the existence
    of a custom or policy or that the alleged policy caused the
    constitutional violation.
    The fact that a physician was called on the night in
    question before Jackson was transferred to an emergency room
    does not establish the existence of the alleged custom, policy, or
    practice for a single incident “is insufficient to prove a policy or
    custom.” Craig, 
    643 F.3d at 1311
    . Furthermore, the existence of
    such a policy or custom is belied by the form authorizing
    Jackson’s transfer to an outside hospital, which expressly provides
    that “[i]f assessment is performed by health staff other than
    clinician, form must be reviewed and signed by a clinician on the
    next working day.” Thus, the transfer form establishes that
    USCA11 Case: 20-14737      Date Filed: 02/02/2022    Page: 14 of 19
    14                     Opinion of the Court               20-14737
    someone other than a physician may authorize the transfer of an
    inmate to an outside hospital.
    Moreover, Jackson’s affidavit in which he asserts that
    Nurse Lewis told him that “we are instructed to find alternative
    treatment options that [are more] cost efficient th[a]n to send an
    inmate to an outside hospital, and if there’s no other options
    available, to contact the on-call physician for approval to send an
    inmate to the hospital” does not create a genuine issue of material
    fact regarding Corizon’s policy or custom because she never
    stated who gave her those instructions. Corizon may not be held
    liable for the acts of its employees unless it sanctioned the acts—
    either through a policy or custom. Nurse Lewis never stated who
    gave her the alleged instruction to contact a physician before
    transferring an inmate to an outside hospital. Therefore, we are
    left to speculate whether it was Corizon that gave her that
    instruction, a prison official, an administrative official, or
    someone else within the prison facility—all of these speculative
    inferences are equally plausible—and speculation is not sufficient
    to overcome summary judgment. Cordoba v. Dillard’s Inc., 
    419 F.3d 1169
    , 1181 (11th Cir. 2005) (explaining that “[s]peculation
    does not create a genuine issue of fact; instead it creates a false
    issue, the demolition of which is a primary goal of summary
    judgment”).
    And regardless, even assuming that Nurse Lewis’s
    statements could establish a custom or policy attributable to
    Corizon, Jackson’s claim that this alleged custom or policy
    resulted in a constitutionally inadequate delay in medical care that
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    20-14737                   Opinion of the Court                                15
    caused him injury rests only on his experience, which is, at most,
    proof of “a single incident of unconstitutional activity.” Craig,
    
    643 F.3d at 1312
     (quotation omitted). He produced no other
    evidence of similar incidents at Columbia Correctional.4 The
    standard for holding a municipality liable under § 1983 is high,
    and proof of a single incident “is not sufficient to impose liability.”
    Id. (quotation omitted).
    Moreover, we note that Jackson failed to establish
    causation between the alleged custom or policy and his injury.
    Specifically, Jackson alleged that the policy or custom caused a
    delay in medical treatment that resulted in his alleged lost lung
    capacity and memory loss. However, he produced no medical
    evidence demonstrating that the injuries he suffered were the
    result of delayed treatment. See Hill v. Dekalb Reg’l Youth Det.
    4 Dr. Pugh’s affidavit and deposition from different lawsuits against Corizon
    are insufficient to create a genuine issue of material fact as to the existence of
    the alleged policy, custom, or practice because Jackson was never an inmate
    at the Chatham County Jail in Georgia where Dr. Pugh worked. Thus, even
    assuming the truth of Dr. Pugh’s statements, there is no evidence that
    Corizon exhibited the same pressure on physicians at Columbia Correctional
    Institute where Jackson was an inmate. Furthermore, Dr. Pugh’s statements
    concern a time period prior to Jackson’s experience. Thus, any relation
    between Dr. Pugh’s statements and Jackson’s case is speculative at best,
    which is insufficient to defeat summary judgment. Cordoba, 
    419 F.3d at 1181
    . For these same reasons, the existence of other lawsuits against
    Corizon involving the provision of medical services to inmates in other jails
    and prisons does not create a genuine issue of material fact as to the
    existence of the alleged policy, custom, or practice at Columbia Correctional
    Institute. 
    Id.
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    16                     Opinion of the Court                20-14737
    Ctr., 
    40 F.3d 1176
    , 1187–88 (11th Cir. 1994), overruled in part on
    other grounds by Hope v. Pelzer, 
    536 U.S. 730
    , 739 n.9 (2002)
    (explaining that when a plaintiff alleges that delay in medical
    treatment constituted deliberate indifference, he “must place
    verifying medical evidence in the record to establish the
    detrimental effect of delay in medical treatment to succeed”).
    Accordingly, because Jackson failed to make a showing
    sufficient to establish the existence of elements essential to his
    case, Corizon was entitled to summary judgment on his
    deliberate indifference claim.
    B. Failure to Train Claim
    Jackson alleged in his complaint that Corizon was liable for
    its failure to train Nurse Lewis on the emergency transfer
    inmates. Jackson argues that the district court erred in entering
    summary judgment on his failure to train claim because there was
    a genuine issue of material fact as to whether Corizon had a
    policy of not requiring or insuring that its staff completed the
    required training as evidenced by the fact that Nurse Lewis failed
    to complete Corizon’s training course on emergency transfer
    procedure.
    Like a municipality, a private entity such as Corizon, may
    be liable for failing to train its employees if “such inadequate
    training can justifiably be said to represent [the entity’s] policy.”
    City of Canton, Ohio v. Harris, 
    489 U.S. 378
    , 390 (1989). “Since
    [an entity] rarely will have an express written or oral policy of
    inadequately training or supervising its employees, . . . a plaintiff
    USCA11 Case: 20-14737        Date Filed: 02/02/2022     Page: 17 of 19
    20-14737                Opinion of the Court                        17
    may prove [an entity’s] policy by showing that the [entity’s]
    failure to train evidenced a ‘deliberate indifference’ to the rights of
    its inhabitants.” Gold v. City of Miami, 
    151 F.3d 1346
    , 1350 (11th
    Cir. 1998). The failure to train must “reflect[ ] a ‘deliberate’ or
    ‘conscious’ choice by a municipality.” Canton, 
    489 U.S. at 389
    .
    “To establish a ‘deliberate or conscious choice’ or such ‘deliberate
    indifference,’ a plaintiff must present some evidence that the
    [entity] knew of a need to train and/or supervise in a particular
    area and the [entity] made a deliberate choice not to take any
    action.” Gold, 
    151 F.3d at 1350
    . “A municipality’s [or entity’s]
    culpability for a deprivation of rights is at its most tenuous where
    a claim turns on a failure to train.” Connick v. Thompson, 
    563 U.S. 51
    , 61 (2011). “A pattern of similar constitutional violations
    by untrained employees is ordinarily necessary to demonstrate
    deliberate indifference for purposes of failure to train.” 
    Id. at 62
    (quotation omitted).
    Here, the record established that Corizon offered training
    courses on “emergency transfer to outside hospital,” which
    undermines Jackson’s contention that Corizon had a custom or
    policy of undertraining its staff. Although Nurse Lewis may not
    have completed the training, there is no evidence that Corizon
    was aware that Nurse Lewis had not completed the course or that
    other medical staff members had not completed this training.
    Furthermore, Jackson failed to produce any evidence of similar
    constitutional violations by other employees at Columbia
    Correctional, and “[a] pattern of similar constitutional violations
    USCA11 Case: 20-14737       Date Filed: 02/02/2022    Page: 18 of 19
    18                     Opinion of the Court                20-14737
    by untrained employees is ordinarily necessary to demonstrate
    deliberate indifference for purposes of failure to train.” 
    Id.
    Although Jackson submitted Nurse Lewis’s disciplinary
    record, those incidents reflect that she was disciplined primarily
    for time and attendance issues.            Only one documented
    disciplinary incident relates to Nurse Lewis’s medical care, where
    Nurse Lewis was given written counseling after another nurse
    complained that Nurse Lewis failed to help during a medical
    emergency. The fact that Nurse Lewis was disciplined for her
    inaction demonstrates that Corizon did not have a policy of
    undertraining its staff or “deliberate[ly] cho[se] not to take any
    action” when it became aware of issues. Gold, 
    151 F.3d at 1350
    (“To establish a ‘deliberate or conscious choice’ or such
    ‘deliberate indifference,’ a plaintiff must present some evidence
    that the municipality knew of a need to train and/or supervise in
    a particular area and the municipality made a deliberate choice
    not to take any action.”); see also Keith v. Dekalb Cnty., 
    749 F.3d 1034
    , 1053 (11th Cir. 2014) (determining that a single prior
    incident did not provide the requisite notice to the supervisor that
    the training provided was constitutionally deficient).
    Accordingly, Jackson failed to make a showing sufficient to
    establish a failure to train claim, and Corizon was entitled to
    summary judgment.
    C. Jackson’s state law claims
    Finally, because summary judgment was appropriate on
    Jackson’s federal § 1983 claims, the district court did not abuse its
    USCA11 Case: 20-14737       Date Filed: 02/02/2022    Page: 19 of 19
    20-14737               Opinion of the Court                       19
    discretion in declining to exercise supplemental jurisdiction over
    the state law claims. See Parker v. Scrap Metal Processors, Inc.,
    
    468 F.3d 733
    , 738, 743 (11th Cir. 2006) (explaining that the district
    court’s decision not to exercise supplemental jurisdiction is
    reviewed for an abuse of discretion, and that, under 
    28 U.S.C. § 1367
    , district courts may decline to exercise such jurisdiction
    when “[it] has dismissed all claims over which it has original
    jurisdiction”); Raney v. Allstate Ins. Co., 
    370 F.3d 1086
    , 1089 (11th
    Cir. 2004) (“We have encouraged district courts to dismiss any
    remaining state claims when, as here, the federal claims have
    been dismissed prior to trial.”).
    Accordingly, we affirm the district court’s grant of
    summary judgment for Corizon.
    AFFIRMED.