After suffering severe complications from contracting influenza H1N1, Manuel Moreno filed a lawsuit against two dozen medical providers and other individuals working at the North Carolina prison where he was incarcerated at the time he fell ill. The claims against all but one of those defendants were resolved leaving state medical malpractice and gross negligence claims and a federal deliberate indifference claim that Moreno brought against Dr. Carol Bosholm, the medical provider who treated Moreno when he first presented symptoms to the prison’s medical facility.
At the close of trial, the district court granted Dr. Bosholm’s renewed motion for judgment as a matter of law, from which Moreno appealed. As part of that appeal, Moreno also challenged a pre-trial ruling excluding evidence from his expert witness as to the appropriate standard of care and causation relating to the medical malpractice claim. Dr. Bosholm filed a cross appeal challenging numerous pre-trial rulings that she claimed should have been decided differently and resulted in judgment in her favor before even reaching trial.
The United States Court of Appeals for the Fourth Circuit stated in its August 15, 2025 published Opinion: “FRE 601 directs federal courts to apply state rules about the competency of any witnesses (including experts) to testify in a case to which FRE 601 otherwise applies, but it does not direct federal courts to apply state rules about the qualities that the expert testimony itself must possess to be admissible … The district court did not abuse its discretion in applying North Carolina Rule of Evidence 702(b) as the basis for deciding if Moreno’s expert witness was qualified to testify as to the standard of care applicable in his medical malpractice claim because FRE 601 directs that federal courts apply such a state competency rule to state claims pursued in federal court. Moreno does not contend that Dr. Bilbro satisfied North Carolina Rule of Evidence 702(b)’s requirements if they applied to the question of his competency to testify about the standard of care applicable to Moreno’s medical malpractice claim. We therefore affirm the district court’s decision to exclude that testimony … Without competent testimony establishing the standard of care or its breach, the claim could not survive Dr. Bosholm’s motion for judgment as a matter of law. Therefore, the district court did not err in entering judgment on that claim in Dr. Bosholm’s favor and we now affirm that part of the judgment.”
Gross Negligence Claim
The Federal appellate court stated: “[W]e disagree with Moreno’s assessment that the trial record permits a finding of “gross” negligence, i.e., willful or wanton conduct evincing a conscious or reckless disregard of Moreno’s health. As the district court observed, it is undisputed that on Friday, February 26, Dr. Bosholm reviewed Nurse Sullivan’s notes, diagnosed Moreno based on his complaints and the results of the physical examination and vital statistics assessed at that time, and rendered instructions for how to proceed (medication, monitoring, and quarantine). At trial, Dr. Bosholm testified that she was “concerned that [the quarantined inmates] might have an infectious disease like influenza,” so she “want[ed] the [weekend] nurses to monitor” them. J.A. 451. Presented with this uncontradicted record that Dr. Bosholm provided some responsive medical care to Moreno on Friday afternoon, Moreno is left with the assertion that what she did was insufficient and that she should have done more to prevent what happened to him. As previously pointed out, however, that sort of argument sounds within the classic parameters of medical malpractice (ordinary negligence) rather than constituting the sort of conduct necessary to show gross negligence … Simply put, the trial record contains no evidence that would elevate Dr. Bosholm’s treatment plan on Friday, February 26, to the stuff of gross negligence as North Carolina recognizes it.”
Deliberate Indifference Claim
“Like North Carolina’s tort of gross negligence, a § 1983 claim predicated on deliberate indifference to serious medical needs requires proof that the defendant acted with a “sufficiently culpable state of mind,” which amounts to something more than negligence but less than intention … Specifically, the second part of a deliberate indifference claim requires proof that the defendant both knew of and disregarded a substantial risk to the plaintiff’s health or safety … However, even officials who acted with deliberate indifference may be free from liability if they responded reasonably to the risk … the Supreme Court has cautioned that the “inadvertent failure to provide adequate medical care” does not amount to deliberate indifference and that “[m]edical malpractice does not become a constitutional violation merely because the victim is a prisoner.””
The Federal appellate court held: “For the same reasons discussed with regard to his gross negligence claim, we reject Moreno’s arguments in support of allowing his deliberate indifference claim to proceed to a jury verdict. The uncontradicted evidence shows that Dr. Bosholm responded to Moreno’s complaints on Friday, February 26. Moreno says that response was inadequate, but “the mere negligent or inadvertent failure to provide adequate care is not enough” to establish deliberate indifference” … Moreno’s speculation about an alternative approach to his treatment that could have averted his injuries is not the same thing as coming forward with evidence that would permit a jury to find that Dr. Bosholm deliberately disregarded a known risk to Moreno’s health when she failed to provide more specific instructions to the weekend staff. And it’s the latter that is required to proceed to a jury … the district court did not err in granting Dr. Bosholm judgment as a matter of law on Moreno’s deliberate indifference claim.”
Source Moreno v. Bosholm, No. 23-6890.
If you or a loved one were injured due to the lack of appropriate medical care in prison in the United States, you should promptly seek the legal advice of a local medical malpractice lawyer in your state who handles prison medical malpractice claims and may investigate your claim and represent you or your loved one, if appropriate.
Visit our website or call us toll-free in the United States at 800-295-3959 to be connected with prison medical malpractice lawyers in your state who may assist you.
Turn to us when you don’t know where to turn.
