UNPUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

YVONNE L. DEAN,

Plaintiff-Appellant,

v. No. 99-2222

UNITED STATES AIR FORCE,

Defendant-Appellee.

Appeal from the United States District Court

for the District of Maryland, at Baltimore.

J. Frederick Motz, Chief District Judge.

(CA-97-1951-JFM)

Submitted: March 23, 2000

Decided: March 31, 2000

Before LUTTIG, WILLIAMS, and MICHAEL,

Circuit Judges.

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Affirmed by unpublished per curiam opinion.

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COUNSEL

Yvonne L. Dean, Appellant Pro Se. Roann Nichols, OFFICE OF THE

UNITED STATES ATTORNEY, Baltimore, Maryland, for Appellee.

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Unpublished opinions are not binding precedent in this circuit. See

Local Rule 36(c).

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OPINION

PER CURIAM:

Plaintiff Yvonne L. Dean appeals the grant of summary judgment

in favor of the United States Air Force in her medical malpractice

action. We affirm.

Dean's complaint, as liberally construed by the district court,

alleges that Air Force medical personnel performed negligently when

treating her in Japan and Maryland. Her chief assertion is that she has

suffered continuous stress and other symptoms due to surgical clips

left in her abdomen during a hernia operation.

The district court dismissed all claims relating to medical services

provided in Japan, and Dean has not challenged that ruling on appeal.

Regarding Dean's claims arising from treatment received in Maryland, the court properly granted the Air Force's motion for summary

judgment because Dean had not proffered any expert evidence establishing a link between the surgical clips and her symptoms. Dean

notes the record contains a letter from an Air Force lawyer expressing

sympathy for her condition, as well as several doctors' notes alluding

to the clips in her abdomen. None of this material, however, amounts

to an expert determination of negligence or harm to Dean. Maryland

law requires such expert testimony in malpractice cases, "[e]xcept in

cases where the medical negligence alleged is of such gross and obvious nature that a layman can comprehend the breach of care." Karl

v. Davis, 639 A.2d 214, 218-19 (Md. Ct. Spec. App. 1994); accord

Holzhauer v. Saks & Co., 697 A.2d 89, 94-95 (Md. 1997). As this

case does not fall into the exception for obvious malpractice, the district court properly granted summary judgment in favor of the Air

Force.

Dean's two remaining claims are unavailing. First, she faults the

district court for not giving her time to retain an expert. The court

granted two continuances for this purpose, however; the denial of a

third was within the court's discretion. See United States v. Lawrence,

161 F.3d 250, 254 (4th Cir. 1998), cert. denied , 526 U.S. 1031

(1999). Second, Dean raises an ambiguous claim relating to disclosure of medical records. As this issue was not presented below, it is

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waived. See Skipper v. French, 130 F.3d 603, 610 (4th Cir. 1997)

(noting general rule that theories presented for the first time on appeal

will not be considered).

For these reasons, we affirm the district court's order. We dispense

with oral argument because the facts and legal contentions are adequately presented in the materials before the court and argument

would not aid the decisional process.

AFFIRMED

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