2009 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit 7-8-2009 

# J ohn D o e v . N J D ept C orr P r e c e de nt i al or N on-P r e c e de nt i al : N on-P r e c e de nt i al D ocke t N o . 07-3189

F o llow thi s and a dd it ion al work s at : http://d i git alc ommon s .l a w . vi ll anova . e du/thir dc ir c uit_2009

Thi s de c i sion i s br ou ght t o you for f r e e and ope n a c c e s s b y the O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit at V i ll anova U nive r sity S choo l of L a

w Di git al Reposit ory

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. N J D ept C orr " (2009). 2009 D e cisio n s . P ape r 1049. http://d i git alc ommon s .l a

w . vi ll anova . e du/thir dc ir c uit_2009/1049NOT P RE CE DE NT I AL UN I TED STATES CO UR T OF A PP EALS F O R T H E T H IR D C IR C U IT N o. 07- 3189 J OH N D OE,

A ppel l ant v. N EW J ER SEY D EPA RT M EN T O F CO RR EC TI O N S; M R . T H O M A S FA R R E L L , D i r ect orof M edi cal Ser vi ces for the N ew j ers eyD epart m ent of C orr ect i on s; CO RR EC TI O N A L M ED I CA L SER V I CE S; D R . G E O R G E A C H E B E , M ed ical S u p erv isor (C M S ); D R . R A Y M U N D O T A G L E (C M S ); S T. F RANCI S M EDI CAL CE NTE R; S USAN F ARBER , R ec o rds A d m inistrator, Sa int Fra n cis M ed ical C en ter; U L T R A S O U N D S E R V IC E S , IN C .; R I C H A R D PU R SE , U l tr a Sound Ser vi ces , I nc.

A p p ea l from the U n it ed S tat es D istri ct C o u rt forthe D i s tr i ctof N ew J er s ey ( D . C . C i vi l A ct i on N o. 03- cv- 02112) D i s tr i ctJ udge: H onor abl e A nne E. T hom ps on Subm i t t ed U nderT hi r d C i r cui tL A R 34. 1( a)

J ul y7, 2009 B efor e: SL O V I T E R , A M B R O , and J O R D A N , C i r cui tJ udges

( O pi ni on fi l ed J ul y08, 2009)2 OP I NI ON A M B R O , C i r cui tJ udge I n M ay2003, J ohn D oe, an i nm at e atN ew J er s eySt at e Pr i s on ( “N J SP”) , br ought s u it a g a in s t, in tera lia , C orr ect i onal M edi cal Ser vi ces ( “C M S”) , a pr i vat e company contr act ed bythe N ew J er s eyD epart m entof C orr ect i ons ( “N J D O C ”) t o s uppl ym edi cal car e t o pr i s on fac i l i t i es . D oe al s o named t w o of C M S’ s i ndepende ntcontr act or phy s i ci ans , D r . G eor ge A chebe and D r . R aym undo T agl e, i n the s ui t . D r . A chebe w as t he m edi cal di r ect orof N J SP, and D r . T agl e w as D oe’ s pr i m arycar e phy s i ci an and the asso ciate m ed ical directo r of N JS P . T h o m as F arrell , the s u p erv isor o f th e N JD O C ’s heal th s ervi ces uni t , w as al s o named. D oe br oughts ever al s t at e and f eder al cl ai m s ar i s i ng outof hi s tr eatm entforthe H e p a tit is C V iru s (“ H C V ” ). T h e se c laim s in c lu d e d : (1 ) d e n ial o f m e d ica l ca re in vi ol at i on of the Ei ghth A m endment , and arbi tr arydi s cr i m i nat i on and deni al of equa l pr ot ect i on i n vi ol at i on of the Four t eenth A m endment , as agai ns tdefe ndant s Farr el l and th e N JD O C ; (2 ) d e lib e ra te in d if f e re n c e to se rio u s m e d ica l n e e d s in v io latio n o f th e E ig h th A m endment , vi ol at i on of, among ot herthi ngs , the Four t eenth A m endmentr i ghtt o due pr oces s , and br eac h of pr ofes s i onal dutyand contr actual obl i gat i on t o pr ovi de medi cal car e, as agai ns tdefe ndant s C M S and D r s . A chebe and Tagl e; and ( 3) w i thhol di ng of c ritica l m e d ica l in f

o rm a tio n a n d re c o rd s a n d d e lay of H C V tre a tm e n t, an d b re a c h o f d u tyH C V is a l iver d isease w ith a v erylon g lat en cyp eriod , n o rm all ytakin g 3 0 to 4 0 y ea rs 1 t o reach it s end-st age. Th e dis ease i s pri m ari l yasym ptom at i c w hen i nd i vidual s ar e fi rs t i nfec t ed, r es ul t i ng i n 60- 85% of thos e i nfec t ed deve l opi ng chr oni c i nfec t i on. I n 2002, t he drug ther apys ucce s s r at e forD oe’ s form of H C V w as appr oxi m at el y40% aft er48 w eeks of ther apy . B eca us e of the hi gh fai l ur e r at e, tr eatm ents t ops aft er12 w eeks i f the pat i ent does notbegi n t o r es pond favor abl y . W hethera pat i ents houl d r ece i ve H C V tr eatm ent d e p e n d s o n th e m a g n itu d e o f v ir a l lo a d re f

le c te d in a b lo o d te s t. See T HE N ATI ON AL I N S T ITU T E S OF H EAL TH C ONSENSUS D EVE L OP MEN T P R OG RAM : M AN AG EMEN T O F H EPATI TI S C (2002 ), U . S . D epart m ent of H eal th & H um an S ervi ces, http:// con sensus. n i h . g o v / 2 0 0 2 He p a t i t i s c 2 0 0 2 1 1 6 h t ml . h t m. 3 u n d er the N ew Jerse yP ati en ts B il l of R igh ts, as a g ains t def

en d an ts Su san F arb er, R icha rd P u rse, U ltraso u n d S y stem s, Inc . , an d S t. F ran cis M ed ical C en ter. T h e D istri ct C o u rt d ism iss e d a ll cla im s e x c e p t f o r D o e ’s c o n stitu tio n a l cla im u n d e r § 1 9 8 3 f o r d e lib e ra te i ndi ffe r ence . T hi s cl ai m pr ocee ded t o tr i al , w hi ch r es ul t ed i n a j uryver di ctforthe defe ndant s . T he D i s tr i ctC our tdeni ed D oe’ s s ubs equentm ot i on fora new tr i al . D oe now appea l s , chal l engi ng s ever al adver s e evi dent i aryand j ury - i ns truct i on rul i ngs and the di s m i s s al of hi s s t at e- l aw cl ai m s . Forthe fol l ow i ng r eas ons , w e af fi r m the deni al of D o e’s m o ti o n fo r a n ew tr ial an d p retri al ruli n g s, b u t r em an d the c ase to the D istri ct C o u rt f o rc l a r i f i c a t i o n o n i t s d i s mi s s a l o f Do e ’ s s t a t e me d i c a l n e g l i g e n c e c l a i m.

I. B eca us e w e w r i t e s ol el yforthe part i es , w e s t at e onl ythe fa ct s r el evantt o our anal y s i s . D oe ent er ed N J SP i n 1999. O n hi s arr i val , he i nform ed off i ci al s thathe pr evi ous l yhad t es t ed pos i t i ve forH C V and as ked aboutt es t i ng and tr eatm ent . A bl ood 1 t es ts how ed D oe w as pos i t i ve forH C V and w arr ant ed tr eatm ent , butthe r es ul t s w er e notT he Feder al B ur eau of Pr i s ons ’ dos age c hartr ecomm ends a dos e of 1200 mg. T he 2 s peci al i s tw ho tr eat ed D oe ( butdi d nothave f i nal author i tyon dos age) t es t i fi ed thathe w oul d have pr es cr i bed 1200 mg, w hi l e def endant s ’ expertt es t i fi ed that800 m g w as an acc ept abl e dos age. 4 rep o rt ed to D o e o r en tered o n h is m ed ical ch art. A n o tat ion w as later m ad e o n D o e’s chartbyD r . T agl e thatH C V w as “notdet ect ed” i n D oe’ s bl ood. A s econd not at i on w as m ade byD r . A chebe thatD oe had de cl i ned tr eatm entand w as pr es cr i bed fol l ow - up i n t he chr oni c ca r e cl i ni c, even though D oe had notcompl et ed a r efus al form . A ft erD r . A chebe ent er ed hi s not at i on, al l of D oe’ s tr eatm ent , i ncl udi ng chr oni c ca r e meas ur es , t erm i nat ed. A ft err eadi ng var i ous art i cl es aboutthe fa i l ur e of CM S and the N J D O C t o t es tand tr e a t p ri s o n e rs f

o r H C V , D o e a s k e d a n a tto rn e yto h e lp h im o b ta in h is m e d ic a l r e c o rd s . W hen D oe ev entual l ygained access t o h i s r ecords, show i ng the u nd i scl osed b l oo d tes t r es ul t s and err oneous “notdet ect ed” not at i on, he w r ot e t o Farr el l , w ho r efe rr ed the mat t er t o CM S w i tho utr e vi e w i ng D oe ’ s c ha r t s orr e fe rr i ng hi m t o a ne w ph y s i c i a n. CM S, thr ough D r . A chebe , then s entD oe t o a s peci al i s tw ho confi r m ed thatD oe qual i fi ed for tr eatm ent . T r eatm entthen bega n, thr ee a nd a hal f y ear s aft erD oe fi r s tadvi s ed off i ci al s of hi s H C V - pos i t i ve s t atus . D r . T agl e pr es cr i bed D oe the FD A - appr oved dos e ( 800 m g) of the drug r i bovi r i n. A ft er12 w eeks of r ece i vi ng m edi cat i on, D oe’ s tr eatm entw as 2 t erm i nat ed bec aus e hi s vi r al l oad had notbeen s i gni fi cant l yr educe d. D oe s ubs equent l yfi l ed a pr o s e c o mp l a i n ti n th e Di s tr i c tCo u r t , a l l e g i n g th e c l a i ms not ed above . T he D i s tr i ctC our tr evi ew ed the compl ai ntpur s uantt o 28 U . S. C . §§ 19155

and 19 15 A , w hich r equ i res a cou rtt o d i sm i ss s ua s pont e anycompl ai ntthatfai l s t o s t at e a cl ai m on w hi ch r el i ef maybe gr ant ed w hen a pr i s onerbr i ngs a ci vi l act i on i n f o r ma p a u p e ris . T he C our trul ed D oe’ s E i ghth A m endmentcl ai m s agai ns tC M S, D r s . A chebe and Tagl e, and Farr el l w er e vi abl e and c oul d pr ocee d t o tr i al . ( T he C our tal s o al l ow ed the sta te- law c laim a g a in st d e f e n d a n ts F a rb e r, P u rse , U ltras o u n d S y ste m s, In c ., a n d S t. F ra n c is M e d ica l C e n ter to p ro c e e d , tho u g h it w a s v o lu n tar ilyw ith d ra w n b yD o e p rio r to tr i al . ) I n i t s rul i ng, the D i s tr i ctC our tm ade no ment i on of D oe’ s s t at e- l aw m edi cal n e g l i g e n c e c l a i m. T h e Di s tr i c tCo u r tma d e s e v e r a l e v i d e n t i a ryru l i n g s a d v e r s e t o Do e d u r i n g two pr etr i al hear i ngs and attr i al . Shor t l ybefor e the tr i al , the C our ti nform ed the part i es that onl ythe fe der al deni al of m edi cal tr eatm entcl ai m coul d go t o tr i al . D oe r es ponded w i th a m ot i on forr econs i der at i on t o r ei ns t at e hi s s t at e- l aw negl i gence cl ai m agai ns tC M S and D rs. A c h e b e a n d T a g le. T h e D istric t C o u rt’s o rd e r d e n y in g th e m o tio n sta ted th is c laim had bee n di s m i s s ed ea r l i eri n t he ca s e, atthe § 1915 s t age, and thatthe C our thad t aken in to c o n sid e ra tio n a ll o f D o e ’s a rg u m e n ts p rio r to its ru lin g th a t o n lyth e E ig h th A m endmentcl ai m coul d pr ocee d. D oe r epr es ent ed hi m s el f attr i al , w hi ch l as t ed s even da y s . Fol l ow i ng a j ury - char ge co n fe ren ce , the C o u rtch o se n o t t o inclu d e se v era l of D o e’s req u ested ch arg es. T h e jury found i n favorof the def endant s . D oe br oughta mot i on fora new tr i al thatw as deni ed byT he D i s tr i ctC our thad j ur i s di ct i on under28 U . S. C . § 1331. W e have j ur i s di ct i on 3 under§ 1291. 6 the C ou rt , and he n ow app eal s. 3 II. W e appl yan abus e- of- di s cr et i on s t andar d w hen r evi ew i ng a D i s tr i ctC our t ’ s rul i ng o n a d m is s io n o r e x c lu s io n o f e v id e n c e , s ee G or don v. Lew is t ow n H os p. , 423 F. 3d 184, 215 n. 21 ( 3d C i r . 2005) ( ci t i ng A f f i l i a t e d Ma n u f a c t u r e rs , I

n c . v . A l u mi n u m C o . o

f A m. , 56 F .3 d 5 2 1 , 5 2 5

– 2 6 (3 d C ir . 1 9 9 5 )) , a n d e x p e rt te s tim o n y , s ee C alhoun v. Y am aha Mot or C or p. , U . S. A . , 350 F. 3d 316, 320 ( 3d C i r . 2003) ( ci t i ng G en. E l ec. C o. v. Joi ner , 52 2 U. S. 1 3 6 , 1 3 8

– 3 9 (1 9 9 7 )) , a s w e ll a s to its d e c is io n re g a rd in g ju ry in s tru c tio n s . See U ni t ed Stat es v. Leahy , 445 F. 3d 634, 642 ( 3d C i r . 2006) ( ci t i ng U n itedS ta tes v . C o

y le , 63 F. 3d 1239, 1245 ( 3d C i r . 1995) ) . D i s m i s s al of s t at e- l aw cl ai m s i s s ubj ectt o de novo re v ie w . See N a ta le v . C a m d e n C o u n ty C o rr e c tio n a l Fa c ili ty , 318 F. 3d 575, 579 ( 3d C i r . 2003) ( ci t i ng Is lan d Inst eelSys. Inc. v. W aters , 2 9 6 F . 3 d 2 0 0 , 2 0 6 (3d C ir . 2 0 0 2 )). III . D oe cha l l enges ( 1) the exc l us i on of evi dence pert ai ni ng t o C M S pol i cy , ( 2) the jurych arg e, (3) the D istri ct C o u rt ’s fa il u re to inv esti g ate a tt o rne ym isco n d u ct, (4) a lim itatio n o n th e tes tim o n yo f h is e x p e rt, an d (5 ) th e re f u sa l to p e rm it h is s tate m a lp ra c tice c laim s to g o to trial. A.7

D oe att empt ed t o pr es entevi dence attr i al thatC M S and the N J D O C had a d e fa c to pol i cyof nottr eat i ng pr i s oner s forH C V . T o br i ng a cl ai m agai ns tD r . A chebe , D r . T agl e, orFarr el l ’ s empl oy er s , C M S and N J D O C , D oe w as r equi r ed t o s how both thatthe empl oy ees vi ol at ed hi s cons t i tut i onal r i ght s , and thattheydi d s o act i ng pur s uantt o a de f acto p o lic yo f

th e ire m p lo y e rs . See N a ta le v . C a m d e n C o u n ty C o rr . Fa c ili ty , 318 F. 3d 575, 585 ( 3d C i r . 2003) . A courthas “w i de di s cr et i on t o admi torexcl ude evi dence under the pr ovi s i ons of the Feder al R ul es of Evi dence . ” G um bs v. I nt ’ lH ar ves t er, I

nc. , 718 F .2 d 8 8 , 9 7 (3 d C ir . 1 9 8 3 ). Th e Di s tr i c tCo u r te x c l u d e d th e t e s t i mo n yo f Ga ryCa mp b e l l , a f

o r me rCM S empl oy ee a nd r egi onal m edi cal di r ect orw hom D oe al l eged de vel oped a pol i cyi n 1999 th a t d isc o u ra g e d C M S p h y sic ian s f ro m tes tin g p riso n e rs f

o r H C V u n til th e yh a d m o d e ra te t o s ever e l i verdi s eas e. T he C our tconcl uded thatthe t es t i m onyw as i rr el evant , as C a m p b e ll h a d w o rk e d in C M S ’s r e g io n a l o f f ice in S t. L o u is a n d th e p o licyh e a lleg e d ly puti n pl ace w as notforthe St at e of N ew J er s ey . T he C our tal s o found thatthi s pol i cy coul d nothave c aus ed D oe’ s del ay ed tr eatm entbeca us e, atthe t i m e the pol i cym emo w as i ssued, D oe w as al readyaw are of his H C V -posi t i ve st atus. T h e D istric t C o u rt a lso e x c lu d e d se v e ra l d o c u m e n ts D o e a ttem p ted to e n ter in to evidence. T he fir st , a reportpu bli shed b ythe N ew Jer seyO ffi ce of L egis l at i ve S ervi ces, s how ed thatC M S submi t t ed a bi d t o N J D O C i n 2002 thatom i t t ed t es t i ng and tr eatm ent for H C V . D oe sou gh tt o p res ent the repo rtt o sho w that C M S did not w ant t o p ayt o tes t8

and tr eatH C V . H ow ever , the C our tfound thatevi dence of cos ts avi ng w oul d nots how an av ers i on t o tes t i ng for or treat i ng H C V , as an i nter esti n “eco no m i c gain” i s a

“ un i ve r s a l mot i ve ” a ta fo r - pr of i tc ompa nys uc h a s CM S. T h e se c o n d d o c u m e n t ex c lu d e d , an H C V Id e n tific a tio n A u d it i ss u e d b yF a rre ll, s how ed C M S fai l ed t o not i fyover440 pr i s oner s of thei rH C V pos i t i ve t es tr es ul t s . D oe a ttem p ted to p re se n t th is a s e v id e n c e o f a sy ste m a tic p ra c tice b yC M S p h y sic ian s to w ith h o ld tes t re su lts f

ro m p riso n e rs, b u t th e C o u rt e x c lu d e d th e d o c u m e n t b e c a u se it f o u n d a n a u d it reg a rd in g tes tin g f o r H C V w a s irre lev a n t to D o e ’s c laim sin c e h e “ se lf r eport ed” hi s condi t i on. T he thi r d excl uded document , a B ur eau of J us t i ce St at i s t i cs R eport , cont ai ned a s ur veys how i ng thatnear l y50% of pr i s oner s t es t ed i n N ew J er s eybetw een J ul y1999 and J une 2000 w er e pos i t i ve forH C V . D oe w ant ed t o pr es entthi s t o es t abl i s h a cus t om or pol i cyof Farr el l

— w ho D oe al l eged w as a “pol i cym aker ”— and the N J D O C r egar di ng H C V . B u t th is r ep o rtw as e x clud ed b ec au se th e D istri ct C o u rtd eterm ined it s resu lt s w ere n o t r e a d ily c a p a b le o f

a c c u ra te a n d re a d yd e te rm in a tio n . See Fed. R . E vi d. 201( b) ( perm i t t i ng a courtt o t ake j udi ci al not i ce of fac t s “nots ubj ectt o r eas onabl e di s put e” that ar e “c apabl e of a ccur at e and r eadydet erm i nat i on byr es or tt o s our ces w hos e ac cur acy ca n n o t r ea so n ab lyb e q u esti o n ed ”). W e bel i eve that , gi ven the w i de di s cr et i on gr ant ed t o a courtt o excl ude evi dence ort es t i m ony , the D i s tr i ctC our tdi d noterri n i t s excl us i onaryrul i ngs . E ven had i terr ed i n excl udi ng C ampbel l ’ s t es t i m onyorthe r eport s , thos e err or s w er e harm l es s beca us e theD o e re q u e ste d th a t th e C o u rt’s c h a rg e in c lu d e h is n e g a tiv e th e o ryo f liab ili tya s to 4 CM S ( e. g. , thata pol i cyorcus t om coul d be s how n w her e a “ pol i cyorpr act i ce w as nom i nal l yi n pl ace , butw as del i ber at el yi gnor ed”) , an i ns truct i on on actual know l edge an d d u tyto p rotec t on the p art of F arrell , an d an instruction o n g ross n eg li g en ce o r a patt ern of negl ecton t he partof D r s . T agl e and A chebe . 9 ju ryd e ter m in e d th a t D o e re c e iv e d a c o n stitu tio n a llya c c e p tab le le v e l o f c a re . In o rd e r to fi nd C M S orN J D O C l i abl e, D oe w as r equi r ed t o s how both ( i ) a de f acto pol i cyof the e m p lo y e r a n d (i i) in

ju ry c a u s e d b yth e e m p lo y e e s a c tin g p u rs u a n t to th e p o lic y . See N a ta le , 318 F. 3d at585. A s D oe es t abl i s hed no i nj uryunderthe Ei ghth A m endment , t he excl us i on of evi dence he pr offe r ed t o s how a C M S orN J D O C pol i cyw as notan abus e of di s cr et i on. B. D oe nextchal l enges s ever al of the D i s tr i ctC our t ’ s j urychar ges , s peci fi cal l ythe fai l ur e t o defi ne de f

acto pol i cyand cus t om orpr act i ce, and the r efus al t o i ns tructon s ever al of hi s l egal theor i es . A di s tr i ctcourthas cons i der abl e di s cr et i on i n the w or di ng 4
o f ju ryinstruction s an d “n ee d n o t give [a ] pro p o sed instruction if esse n ti al po ints are cover ed bythos e thatar e gi ven. ” G ra zie r ex re l. W h ite v . C ity o

f P h ila d e lp h ia , 328 F. 3d 120, 127 ( 3d C i r . 2003) ( quot i ng D ouglas v. O w ens , 5 0 F .3 d 1 2 2 6 , 1 2 3 3 (3 d C ir . 1 9 9 5 )) . A tr i al court“does notabus e i t s di s cr et i on byr efus i ng t o emphasi ze l egal i nfer ence s favor i ng one s i de. E m phas i zi ng ar guabl e i nfer ence s t o j ur or s i s the j ob of advoc at es , not court s . ” I

d. ( ci t i ng B r ew erv. C i t

y of N apa , 2 1 0 F . 3 d 1 0 9 3 , 1 0 9 7 (9th C ir . 2 0 0 0 )). T he D i s tr i ctC our t ’ s expl anat i on of the l aw on de f acto pol i cyand cus t om or10

pr act i ce i n t he j urychar ge cove r ed the es s ent i al poi nt s and made cl earthat , as D oe ar gued, thos e el ement s coul d be s how n i ndi r ect l ythr ough C M S’ s empl oy ees . T he C our t ’ s i ns truct i ons fai r l yand ade quat el ycover ed the i s s ues pr es ent ed and a l l ow ed D oe t o ar gue hi s theoryof the ca s e t o the j ury . T hus , i t s r efus al t o i ncl ude s peci fi c l anguage or i ns tructon part i cul arl egal ar gum ent s r eques t ed byD oe w as notan abus e of di s cr et i on. C. D o e a lso c h a llen g e s th e f a ilu re o f th e D istric t C o u rt to c o n d u c t a h e a rin g in r el at i on t o t he t es t i m onyof hi s w i tnes s , E l i zabe th Fl et cher . D oe al l eges Fl et cherm ade i ncons i s t ents t at ement s attr i al as the r es ul tof comm uni cat i on w i th a def ens e att orney pri or t o tr i al . T his w as not di scl osed to D oe, and thu s he al l eges i tviol at ed d efen dan t s’ obl i gat i on t o pr ovi de di s coveryunderFeder al R ul e of Ci vi l Pr ocedur e 26. A ttr i al , the C our ts t at ed thatthe i ncons i s t ents t at emental one di d noti m pl yi m pr opercomm uni cat i on, and D oe neve robj ect ed, m oved t o s tr i ke, orr eques t ed a he ar i ng w i th r egar d t o the t es t i m onyorcomm uni cat i on. B eca us e Fl et cherw as a non- partyw i tnes s , defe ns e couns el w a s e n title d to s p e a k to h e r a b o u t h e r a n tic ip a te d te s tim o n y , s ee G re in e r v . W e lls , 417 F .3 d 3 0 5 , 3 2 2 (2 d C ir. 2 0 0 5 ), an d th e D istric t C o u rt c o m m itt e d n o e rro r in n o t su a sp o n te h o l d i n g a h e a r i n g o n h e rt e s t i m o n y. D. T he D i s tr i ctC our tl i m i t ed the t es t i m onyfr om D oe’ s expertw i tnes s , D r . E s t eban M e z e y . I tp r e v e n t e d Do e f r o m q u e s t i o n i n g Dr . M e z e ya b o u twh a td o s e o f HCV m ed icati o n h e w o u ld h av e p resc ri b ed fo r D o e (so m ethin g n o t add resse d in D r. M ez ey ’s11

expertr eport ) . T hi s , D oe ar gues , unfai r l ypr ej udi ced hi s cas e. T he pr obl em i s thatthe C our t ’ s deci s i on t o r es tr i ctD r . M eze y ’ s t es t i m onyt o opi ni ons i n hi s r eport

— t o pr event u n fa irsu rprise to d ef

en d an ts— ac co rde d w ith F ed era l R u les o f C ivil P roc ed u re 26( a) ( 2) ( B ) ( I ) and 37( c) ( 1) ; thus i tw as notan abus e of di s cr et i on. E. Fi nal l y , D oe cha l l enges the D i s tr i ctC our t ’ s di s m i s s al of hi s s t at e mal pr act i ce cl ai m s agai ns tC M S, D r . T agl e, and D r . A chebe , cl ai m i ng thathe ca r eful l ypl eade d a c a u se o f a c tio n u n d e r N e w Je rse ym e d ica l m a lp ra c tice law . T h e C o u rt im p licitly di s m i s s ed thi s cl ai m atthe § 1915 hea r i ng w hen i tdi d nots t at e the cl ai m w as vi abl e and coul d pr ocee d. H ow ever , i tal s o di d nots t at e thatthe cl ai m w as di s m i s s ed, and pr ovi ded no s ubs t ant i ve ana l y s i s as t o w hyi tl acke d m er i t . I f i tdet erm i ned thatD oe w as br i ngi ng a me d i c a l n e g l i g e n c e c l a i m u n d e r§ 1 9 8 3 a n d th u s d i s mi s s e d th e c l a i m a s f r i v o l o u s , we w oul d aff

i r m , as “[i ] ti s w el l - s ett l ed thatcl ai m s of negl i gence orm edi cal m al pr act i ce, w ith o u t som e m o re c u lpab le st ate o f m ind , d o n o t con sti tute ‘de li b era te i n d iffe ren ce [ ]’” f o r p u rp o s e s o f

a n E ig h th A m e n d m e n t c la im e n title d to re m e d yu n d e r § 1 9 8 3 . R ous e v. P lant i er , 1 8 2 F . 3 d 1 9 2 , 1 9 7 (3d C ir . 1 9 9 9 ). If , h o w e v e r, th e C o u rt c o n stru e d D o e ’s c a u se o f a c tio n a s a sta te- law c laim , it s houl d nothave be en di s m i s s ed as fr i vol ous . D oe compl i ed w i th N ew J er s eys t at e l aw by s ubm i t t i ng an A ffi davi tof M er i tfr om D r . M eze y , as “the under l y i ng fac tual al l egat i ons of the cl ai m r equi r e[d] pr oof of a devi at i on fr om the pr ofes s i onal s t andar d of ca r e fort hat s peci fi c pr ofes s i on. ” See C our iv. G ar dner , 801 A . 2d 1134, 1141 ( N . J . 2002) ( di s cus s i ngT o pr evai l on a cl ai m underthe Ei ghth A m endment , a pl ai nt i ff musts how that 5 d e f e n d a n ts w e re d e lib e ra te ly in d if f e re n t to a s e ri o u s m e d ic a l n e e d . Far m erv. B r ennan , 5 1 1 U .S . 8 2 5 , 8 4 2 (1 9 9 4 ); Este lle v . G a m b le , 429 U . S. 97, 104–05 ( 1976) . U nderN ew J er s eyL aw , t o es t abl i s h a pr i m a f aci e cas e of ne gl i gence i n a medi cal m al pr act i ce a ct i on al l egi ng devi at i on fr om the s t andar d of ca r e, “a pl ai nt i ff mustpr es entexpertt es t i m ony es t abl i s hi ng ( 1) the appl i cabl e s t andar d of ca r e; ( 2) a devi at i on fr om thats t andar d of ca r e; and ( 3) thatthe devi at i on pr oxi m at el ycaus ed the i nj ury . ” Tei lhaberv. G r eene , 727 A . 2d 5 1 8 , 5 2 4 (N . J. S u p er. C t. A p p . D iv. 19 9 8 ) (cit ati o n s o m itted). “[N ew J er s ey ] m edi cal m al pr act i ce a ct i ons ar e governed bya tw o- y ears t atut e of 6 lim ita tio n s . . . . N . J. S TAT . A NN . § 2A : 14- 2. T he fi l i ng of a f eder al compl ai ntt ol l s the runni ng of the s t atut e of l i m i t at i ons on anys t at e l aw cl ai m s as s ert ed i n the fe der al c o mp l a i n t . 2 8 U. S . C. A. § 1 3 6 7 ( d ) . W h e n a f e d e r a l c o u r td i s mi s s e s th e s t a t e - l a w c l a i ms w ith o u t p re

ju d ic e , th e to llin g c o n tin u e s f o r a n a d d itio n a l p e ri o d o f th ir ty d a y s . Ib id . ” Fear on v. C or r ect i onalMedi cal Ser vi ces , I

nc. , 2 0 0 9 W L 3 9 5 4 7 3 , at * 2 (N .J. S u p e r. C t. A p p . D iv. Fe b . 1 9 , 2 0 0 9 ). 12 N . J. S TAT . A NN . 2 A :53 A -27 ). D o e’s state-l aw n eg li g en ce claim req u ir ed a low er stan d ard o f p r o o f th a n h i s f

e d e r a l c l a i m, a n d a r o s e f r o m th e s a me s e to f

f a c t s a n d a g a i n s tth e s a me 5 defe ndant s as D oe’ s al l eged de ni al of ade quat e medi cal tr eatm entcl ai m s vi ol at i ng the E ig h th A m e n d m e n t, w h ich th e C o u rt p e rm itt e d to p ro c e e d to trial. W e th u s re m a n d th e s ta te -l a w c la im f o r c la ri f ic a tio n f ro m th e D is tr ic t C o u rt . Shoul d i tdet erm i ne thati tdi s m i s s ed D oe’ s pr oper l ypl eade d s t at e medi cal m al pr act i ce c laim a g a in st C M S , D r. T a g le, o r D r. A c h e b e , w e re c o m m e n d d ism iss in g th a t cla im wi th o u tp r e

j u d i c e s o th a tDo e ma yp r o c e e d o n i ti n a s t a t e f o ru m. 6 * * * * * Forthes e r eas ons , w e af fi r m the D i s tr i ctC our t ’ s pr etr i al rul i ngs and i t s deni al of D oe’ s m ot i on fora new tr i al , butr emand t he ca s e forcl ar i fi cat i on on the di s m i s s al of the s t a t e - l a w ma l p r a c t i c e c l a i m.