Howell v. Cataldi, 464 F.2d 272 (3rd Cir. 1972); Roberts v. Williams, 456 F.2d 819 (5th Cir. 1971), cert. denied, 404 U.S. 866 [ 92 S.Ct. 83, 30 L.Ed.2d 110], . . . The standard of liability in a case alleging cruel and unusual punishment relating to a claimed omission of medical care is whether the plaintiff proves exceptional circumstances and conduct so grossly incompetent, inadequate or excessive as to shock the conscience or to be intolerable to basic fairness. Gittlemacker v. Prasse, 428 F.2d 1 (3rd Cir. 1970); Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970). Failure to procure urgently needed medical attention may amount to cruel and unusual punishment.

The standard of liability in a case alleging cruel and unusual punishment relating to a claimed omission of medical care is whether the plaintiff proves exceptional circumstances and conduct so grossly incompetent, inadequate or excessive as to shock the conscience or to be intolerable to basic fairness. Gittlemacker v. Prasse, 428 F.2d 1 (3rd Cir. 1970); Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970). Failure to procure urgently needed medical attention may amount to cruel and unusual punishment.

Hence, even if a prison doctor is mistaken or negligent in his diagnosis or treatment, no constitutional issue is raised absent evidence of abuse, intentional mistreatment, or denial of medical attention. Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970). And where the claim is based merely on a difference of opinion between the prisoner and the doctor over matters of legitimate medical judgment, the claim fails to raise a constitutional question.

Page v. Sharpe, 487 F.2d 567 (1st Cir. 1973).         The matter has been passed on in the Western District of Virginia where, in Bishop v. Cox, 320 F.Supp. 1031, 1032 (W.D.Va.1970), Judge Dalton said:         There have been a number of recent cases dealing with allegations by prisoners that they have not received proper medical attention. Unless allegations of terrible or shocking neglect were made, however, the courts have been unwilling to interject themselves into this area of prisoner administration.

Even if institutional physicians are negligent or mistaken in their diagnosis, such error does not raise a constitutional issue in the absence of abuse, mistreatment, or denial of medical attention. Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970). The law is clear on the issues raised by petitioner and mere negligence, without more, by prison guards and physicians does not support a claim under 42 U.S.C. § 1983.

While claims of deprivation of medical attention can give rise to a constitutional tort under the most extreme circumstances, prison officials are given wide discretion in administering medical treatment to inmates. Prewitt v. State of Arizona ex rel. Eyman, 315 F. Supp. 793 (D.Ariz. 1969), aff'd 418 F.2d 572, cert. denied, 397 U.S. 1054, 90 S.Ct. 1395, 25 L.Ed.2d 670, rehearing denied, 398 U.S. 915, 90 S.Ct. 1703, 26 L.Ed.2d 81; Swain v. Garribrant, 354 F. Supp. 631 (E.D.N.C. 1973). For a complaint to properly allege a failure to provide a prisoner with medical care in violation of his fourteenth and/or eighth amendment rights it must suggest the possibility of some "conduct that shocks the conscience" or a "barbarous act". Church v. Hegstrom, 416 F.2d 449 (2nd Cir, 1969); Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970). For a denial of medical treatment for a prisoner to be actionable under Section 1983, in the absence of a showing of intent to cause harm, courts have generally relied upon the presence of severe and obvious injuries.

Plaintiff has not made a factual presentation of abusive mistreatment or total deprivation of medical care. See Cates v. Ciccone, 422 F.2d 926 (8th Cir. 1970); Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970); Argentine v. McGinnis, 311 F. Supp. 134 (S.D.N.Y. 1969). Rather, he asserts, at most, a difference of opinion regarding the type of medical care appropriate for his dental ailments.

Even if an institutional physician has been negligent or mistaken in his diagnosis, such an error would not raise a constitutional issue cognizable in a § 1983 action in the absence of some evidence of abuse, mistreatment or denial of essential medical attention. See, e.g., Bishop v. Cox, 320 F. Supp. 1031 (W.D.Va. 1970). Petitioner certainly has not been denied medical care.