IN THE UNITED STATES DISTRICT COURT 

FOR THE MIDDLE DISTRICT OF PENNSYLVANIA 

ROBERT L. LONGO JR., 

Plaintiff 

V. 

HANNAH TROSTLE, RNS, MR. 

ARQUELLES, PA, DR. VOORSTAD, 

Defendants 

Civil No. 3:22-cv-1199 

(Judge Mariani) 

MEMORANDUM 

Plaintiff Robert Longo ("Longo"), an inmate housed at the State Correctional 

Institution, Camp Hill, Pennsylvania ("SCI-Camp Hill"), commenced this civil rights action 

pursuant to 42 U.S.C. § 1983. (Doc. 1). Named as Defendants are Nurse Trostle, 

Physician Assistant Arquelles, and Dr. Voorstad. On October 11, 2022, Defendant Trostle 

filed a motion (Doc. 18) to dismiss the original complaint. By Memorandum and Order 

dated June 6, 2023, the Court dismissed the Eighth Amendment claims against Defendant 

Trostle. (Docs. 25, 26). The Court also dismissed the medical malpractice claim against 

Defendant Trostle, but granted Longo leave to amend only with respect to that claim. (Id.). 

On June 23, 2023, Longo filed an amended complaint. (Doc. 27). 

Before the Court is Defendant T rostle's Rule 12(b) motion ( Doc. 29) to dismiss the 

amended complaint. Longo failed to respond to the motion and the time for responding has 

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now passed. 1 Therefore, the motion is deemed unopposed and ripe for resolution. For the 

reasons set forth below, the Court will grant the motion. 

I. Allegations of the Complaint & Amendment 

On April 22, 2021 , Longo began to experience back pain and submitted a sick call 

slip. (Doc. 1 f 3). Defendant Arquelles, a physician's assistant, examined Longo the 

following day. (Id. f 4). Defendant Arquelles prescribed painkillers and muscle relaxers 

and ordered x-rays. (Id.). On May 6, 2021 , Longo underwent x-rays of his lower lumber 

area. (Id. f 5). Longo alleges that he continued to experience pain, and, on May 17, 2021 , 

he submitted a second sick call slip. (Id. f 6). On May 18, 2021 , Defendant Arquelles again 

examined Longo and prescribed a different pain medication, Celebrex. (Id. f 7). Longo 

asserts that he continued to experience pain until he received the Celebrex on May 23, 

2021. (Id. f 8). 

On June 7, 2021 , Defendant Arquelles examined Longo and informed him that the xrays taken on May 6, 2021 were normal. (Id. f 10). Longo requested a second opinion 

from a spinal specialist, but his request was denied. (Id. W 9, 10). 

From July 2021 through October 2021 , Longo submitted at least nine (9) more sick 

call slips complaining of lower back pain, requesting an opinion by a spinal specialist, and 

requesting a bottom bunk. (Id. W 11-31). Longo alleges that, on some occasions, he was 

1 Longo was directed to file a brief in opposition to Defendant Trestle's motion and was 

admonished that failure to file an opposition brief would result in Defendant's motion being deemed 

unopposed. (Doc. 44) (citing M.D. PA. LOCAL RULE OF COURT 7.6). 

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not treated by medical staff. (Id.). On other occasions, Longo states that he was examined 

by the prison medical staff, including Defendant Dr. Voorstad. (Id.). His requests for an 

evaluation by a spinal specialist were repeatedly denied. (Id.). Longo was prescribed 

steroids, anti-inflammatory medication, muscle relaxers, given a back brace, and put on 

bottom-bunk status. (Id. ii 19, 28). Longo contends that these treatments were not 

entirely effective, and his back pain continued. (Id. ii 21, 29). 

During this time period, Longo submitted several unsuccessful grievances 

complaining about his medical treatment and requesting a consult with an outside spinal 

specialist. (Id. fflf 33-41 ). On June 16, 2021, Defendant Nurse Trostle responded to one 

grievance and upheld the denial of Longo's request to see a spinal specialist. (Id. ; Doc. 1-

4). Longo also alleges that he submitted request slips to Defendant Trostle, "all to no avail." 

(Doc. 1 i 31). 

In the amendment to the complaint, Longo alleges that he continues to suffer from 

lower back issues. (Doc. 27). He alleges that "[a]II Defendants" breached their duty by 

denying him access to appropriately qualified health care personnel, failed to refer him to a 

spinal specialist, failed to provide treatments that could eliminate his pain and suffering "at 

least temporarily," delayed access to medical personnel, and prescribed seizure medication 

that they claimed would ease his pain. (Id. ii 6-7, 9, 11). 

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II. Legal Standard 

A complaint must be dismissed under Federal Rule of Civil Procedure 12(b)(6), if it 

does not allege "enough facts to state a claim to relief that is plausible on its face." Be// At!. 

Corp. v. Twombly, 550 U.S. 544, 570, 127 S. Ct. 1955, 167 L. Ed. 2d 929 (2007). The 

plaintiff must aver "factual content that allows the court to draw the reasonable inference 

that the defendant is liable for the misconduct alleged." Ashcroft v. Iqbal, 556 U.S. 662, 129 

S. Ct. 1937, 1949, 173 L. Ed. 2d 868 (2009). 

"Though a complaint 'does not need detailed factual allegations, ... a formulaic 

recitation of the elements of a cause of action will not do."' De/Rio-Mocci v. Connolly Prop. 

Inc., 672 F.3d 241 , 245 (3d Cir. 2012) (citing Twombly, 550 U.S. at 555). In other words, 

"[fjactual allegations must be enough to raise a right to relief above the speculative level." 

Covington v. Int'/ Ass'n of Approved Basketball Officials, 710 F.3d 114, 118 (3d Cir. 2013) 

(internal citations and quotation marks omitted). A court "take[s] as true all the factual 

allegations in the Complaint and the reasonable inferences that can be drawn from those 

facts, but . .. disregard[s] legal conclusions and threadbare recitals of the elements of a 

cause of action, supported by mere conclusory statements." Ethypharm S.A. France v. 

Abbott Laboratories, 707 F.3d 223,231, n.14 (3d Cir. 2013) (internal citations and quotation 

marks omitted). 

Twombly and Iqbal require [a district court] to take the following three steps to 

determine the sufficiency of a complaint: First, the court must take note of the 

elements a plaintiff must plead to state a claim. Second, the court should 

identify allegations that, because they are no more than conclusions, are not 

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entitled to the assumption of truth. Finally, where there are well-pleaded 

factual allegations, a court should assume their veracity and then determine 

whether they plausibly give rise to an entitlement for relief. 

Connelly v. Steel Valley Sch. Dist., 706 F.3d 209, 212 (3d Cir. 2013). 

"[W]here the well-pleaded facts do not permit the court to infer more than the mere 

possibility of misconduct, the complaint has alleged - but it has not show[n] - that the 

pleader is entitled to relief." Iqbal, 556 U.S. at 679 (internal citations and quotation marks 

omitted). This "plausibility" determination will be a "context-specific task that requires the 

reviewing court to draw on its judicial experience and common sense." Id. 

However, even "if a complaint is subject to Rule 12(b )(6) dismissal, a district court 

must permit a curative amendment unless such an amendment would be inequitable or 

futile." Phillips v. Cnty. of Allegheny, 515 F.3d 224, 245 (3d Cir. 2008). 

Id. 

[E]ven when plaintiff does not seek leave to amend his complaint after a 

defendant moves to dismiss it, unless the district court finds that amendment 

would be inequitable or futile, the court must inform the plaintiff that he or she 

has leave to amend the complaint within a set period of time. 

Ill. Discussion 

A. Eighth Amendment Deliberate Indifference Claim 

In the amendment, Longo alleges that "[a]II Defendants" violated his rights under the 

Eighth Amendment. (Doc. 27 fflf 5-7). However, in the June 6, 2023 Memorandum and 

Order, the Court granted Defendant Trestle's motion to dismiss the Eighth Amendment 

claim, and found that granting leave to amend with respect to this claim would be futile. 

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(Docs. 25, 26). Longo was granted leave to amend only with respect to his medical 

malpractice claim against Defendant Trostle. (Id.). Therefore, to the extent that the 

amendment sets forth an Eighth Amendment claim against Defendant Trostle, this claim will 

be dismissed. 

B. Federal Rule of Civil Procedure Rule 8(a) 

Defendant Trostle next argues that Longo's amended complaint fails to comply with 

Federal Rule of Civil Procedure 8 and is a "shotgun pleading." (Doc. 35, pp. 5-8). 

Federal Rule of Civil Procedure 8 establishes the general rules of pleading. See 

FED. R. CIV. P. 8. Rule 8(a) requires a pleading to contain "a short and plain statement of 

the claim showing that the pleader is entitled to relief." FED. R. CIv. P. 8(a)(2). Rule 8(d)(1) 

speaks to factual allegations, requiring that "[e]ach allegation ... be simple, concise, and 

direct." FED. R. CIV. P. 8(d)(1 ). These rules task the plaintiff to provide "the defendant 

notice of what the ... claim is and the grounds upon which it rests." Phillips, 515 F.3d at 

232 (quoting Twombly, 550 U.S. at 555). This standard requires more than legal labels and 

conclusory assertions: a complaint must include enough facts to "raise a right to relief above 

the speculative level." Twombly, 550 U.S. at 555. 

Complaints that violate Rule 8 are often referred to as "shotgun pleadings." See 

Bartol v. Barrowclough, 251 F. Supp. 3d 855,859 (E.D. Pa. 2017). "The Third Circuit has 

criticized 'the all too common shotgun pleading approach' to complaints," which conflicts 

with the mandates of Rule 8(a)(2). See id. (quoting Hynson v. City of Chester Legal Dep't, 

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864 F.2d 1026, 1031, n.13 (3d Cir.1988)). The Court of Appeals for the Eleventh Circuit 

has addressed shotgun pleadings in detail, and "district courts within the Third Circuit often 

cite to the Eleventh Circuit for this law." Id. at 859, n.3; see Weiland v. Palm Beach County 

Sheriff's Office, 792 F.3d 1313, 1320-1323 (11th Cir. 2015). There are four readily 

identifiable categories of shotgun pleadings, including complaints that (i) contain multiple 

counts where each count adopts the allegations of all preceding counts; (ii) are replete with 

conclusory, vague, and immaterial facts not obviously connected to any particular cause of 

action; (iii) do not separate into each count each cause of action or claim for relief; and (iv) 

assert multiple claims against multiple defendants without specifying which of them are 

responsible for which acts or omissions. Bartol, 251 F. Supp. 3d at 859 (citing Weiland, 792 

F .3d at 1321-1323). "And, although there are several characteristics that can make a 

complaint a shotgun pleading, they all have in common one thing: 'fail[ure] to give the 

defendants adequate notice of the claims against them and the grounds upon which each 

claim (ests."' Grande v. Starbucks Corp., Civil Action No. 18-04036, 2019 WL 1455445 at 

*3 (E.D. Pa. Apr. 1, 2019). 

Although Longo's amended complaint has some of the characteristics of a shotgun 

pleading, the Court will not dismiss the action on this ground. The Court will proceed to 

address Longo's medical negligence claim. 

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C. Medical Negligence Claim 

Under Pennsylvania law, medical negligence "can be broadly defined as the 

unwarranted departure from generally accepted standards of medical practice resulting in 

injury to a patient, including all liability-producing conduct arising from the rendition of 

professional medical services." Toogood v. Owen J. Rogal, 0.0.S., P.C. , 573 Pa. 245, 254-

55 (2003) (internal citations and quotations omitted). Thus, a plaintiff must establish a duty 

owed by the physician or medical personnel to the patient, a breach of that duty, that the 

breach was the proximate cause of the plaintiffs injury, and that the damages suffered were 

a direct result of the harm. Toogood, 573 Pa. at 254-55. In addition, "[w]ith all but the most 

self-evident medical malpractice actions there is also the added requirement that the plaintiff 

must provide a medical expert who will testify as to the elements of duty, breach, and 

causation." Quinby v. Plumsteadvil/e Family Practice, Inc., 589 Pa. 183, 199 (2006); see 

also Brady v. Urbas, 111 A.3d 1155, 1162 (Pa. 2015) ("Except in the most obvious cases of 

negligence (such as where a gauze pad is left inside a patient's body), expert testimony is 

necessary to establish the standard of care."); Toogood, 573 Pa. at 254-55 ("Because the 

negligence of a physician encompasses matters not within the ordinary knowledge and 

experience of laypersons a medical malpractice plaintiff must present expert testimony to 

establish the applicable standard of care, the deviation from that standard, causation and 

the extent of the injury." (internal citations and quotations omitted)). 

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Pennsylvania Rule of Civil Procedure 1042.3 further requires a plaintiff alleging 

professional negligence to file a certificate of merit within 60 days of filing the complaint. 

PA. R. CIV. P. 1042.3. The certificate must include one of the following: a written attestation 

by "an appropriate licensed professional" that there is a "reasonable probability that the 

care, skill or knowledge exercised or exhibited" by the defendant "fell outside acceptable 

professional standards," and that this was the cause of the plaintiffs injuries; a statement 

that the claim against the defendant is based only on the professional negligence of those 

for whom the defendant is responsible; or a statement that expert testimony is unnecessary 

for the plaintiffs claim to proceed. PA. R. CIV. P. 1042.3(a)(1)-(3). Should a plaintiff certify 

that expert testimony is unnecessary, "in the absence of exceptional circumstances the 

attorney is bound by the certification and, subsequently, the trial court shall preclude the 

plaintiff from presenting testimony by an expert on the questions of standard of care and 

causation." PA. R. CIV. P. 1042.3(a)(3). Failure to file a certificate of merit is fatal to a 

plaintiffs claim. PA. R. CIV. P. 1042.7. 

Here, Longo appears to assert that he has satisfied the requirements of 

Pennsylvania's certificate of merit requirements by stating under Rule 1042.3(a)(3), that 

"expert testimony of an appropriate licensed professional is unnecessary for prosecution of 

the claim." (Doc. 27, p. 2). The Pennsylvania Rules of Civil Procedure clearly state that a 

plaintiff is bound by his certification that "an expert is unnecessary for the prosecution of the 

claims, in the absence of exceptional circumstances." PA. R. C1v. P. 1042.3(a)(3). The 

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Rules further state that as a result of such certification, "the trial court shall preclude the 

plaintiff from presenting testimony by an expert on the questions of standard of care and 

causation." Id. (emphasis added); see also Liggon-Redding v. Estate of Sugarman, 659 

F.3d 258, 265 (3d Cir. 2011) ("[T]he consequence of ... filing [a certificate of merit] is a 

prohibition against offering expert testimony later in the litigation, absent exceptional 

circumstances." (internal quotations omitted)). Prose plaintiffs are not excluded from the 

binding and preclusive effects of a section (a)(3) certification. Illes v. Beaven, No. 1 :12-CV0395, 2012 WL 2836581 , at *4 (M.D. Pa. July 10, 2012) (explaining that the prose plaintiffs 

(a)(3) certification that "he does not need expert testimony precludes him from presenting 

such testimony"). Nor does a plaintiffs prose status constitute an "exceptional 

circumstance" sufficient to override the expert testimony prohibition. Cuevas v. United 

States, Civil Action No. 09-43J, 2013 WL 4500470, at *10 (W.D. Pa. Aug. 21, 2013) aff'd, 

580 F. App'x 71 (3d Cir. 2014). 

In this case, as stated above, Longo filed a certificate of merit in which he declared: 

"expert testimony of an appropriate licensed professional is unnecessary for prosecution of 

the claim against this Defendant." (Doc. 27, p. 2). As this certification falls within section 

(a)(3) of the Pennsylvania Rules of Civil Procedure, Longo is therefore barred from offering 

expert testimony later in this litigation. Again, Pennsylvania law requires expert testimony to 

establish a claim for medical negligence. Therefore, without the ability to present expert 

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testimony, Longo is unable to establish a prima facie case for medical negligence, and 

therefore, cannot succeed on this claim. 

Longo, however, appears to argue that expert testimony is unnecessary and seems 

to urge this Court to apply the exception to the requirement of expert testimony in medical 

negligence cases. As mentioned briefly above, the Pennsylvania Supreme Court has 

defined a narrow exception to the expert testimony requirement where "the matter is so 

simple or the lack of skill or care so obvious as to be within the range of experience and 

comprehension of even non-professional persons, also conceptualized as the doctrine of 

res ipsa loquitur." Toogood, 573 Pa. at 255 (internal citations omitted). Adopting the 

language of the Restatement (Second) of Torts, Section 3280, the Pennsylvania Supreme 

Court has stated that res ipsa loquitur applies when three conditions are met, "(a) either a 

lay person is able to determine as a matter of common knowledge, or an expert testifies, 

that the result which has occurred does not ordinarily occur in the absence of negligence; 

(b) the agent or instrumentality causing the harm was within the exclusive control of the 

defendant; and (c) the evidence offered is sufficient to remove the causation question from 

the realm of conjecture, but not so substantial that it provides a full and complete 

explanation of the event." Toogood, 573 Pa. at 262 (citing Restatement (Second)§ 3280) 

(emphasis added). 

Longo seems to argue that the circumstances of this case are such that a lay person 

could easily understand them and, therefore, fall within the stated exception. The Court 

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finds that the medical issues presented by Longo require medical testimony and do not fall 

within the exception to the requirement of expert testimony. Arriving at a medical diagnosis 

and then determining the appropriate medical treatment plan is complicated and requires 

medical judgment. In evaluating the prison medical personnel's opinions and treatment of 

Longo's back pain, the fact finder would need more than his common knowledge and 

experience as a layperson. Thus, the Court finds that the narrow exception does not apply, 

and medical expert testimony is required to prove both the standard of care and causation 

for Longo's medical negligence claim. See Cuevas, 2013 WL 4500470, at *10, aff'd, 580 F. 

App'x 71 (3d Cir. 2014) (finding that a determination regarding whether delayed diagnosis of 

a foot injury constitutes medical malpractice "involves complex issues of medical care" and, 

therefore, the narrow exception to the expert testimony requirement does not apply). 

Defendant Trestle's motion to dismiss the medical negligence claim will be granted. 

IV. Leave to Amend 

Generally, "plaintiffs who file complaints subject to dismissal .. . should receive leave 

to amend unless amendment would be inequitable or futile." Grayson v. Mayview State 

Hosp. , 293 F.3d 103, 114 (3d Cir. 2002). Because the exceptions to filing a certificate of 

merit under Pennsylvania law do not apply to Longo's claims, his claim fails as a matter of 

law. The Court thus concludes that allowing further leave to amend would be both futile and 

inequitable. See Grayson, 293 F.3d at 108; see a/so Jones v. Unknown 0.0.C. Bus Driver 

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& Transp. Crew, 944 F.3d 478, 483 (3d Cir. 2019) (where inmate plaintiff "has already had 

two chances to tell his story ... giving him further leave to amend would be futile."). 

V. Conclusion 

For the reasons set forth above, the Court will grant the motion (Doc. 29) to dismiss 

by Defendant Trostle. A separate Order shall issue. 

Robert D. • ni 

Dated: January J!/-, 2024 

United States District Judge 

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