# Gayle v. United States

> District Court, M.D. Pennsylvania · March 25, 2025

URL: https://www.frixlaw.com/law-library/cases/10830479

## Case

- **Court:** District Court, M.D. Pennsylvania
- **Decided:** March 25, 2025
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/10830479

## How later opinions describe it (automated extraction)

- holding that “administrative review mechanisms” can provide “meaningful redress and thereby foreclose[] the need to fashion a new, judicially crafted cause of action[,]” even if those mechanisms do not “fully remedy the constitutional violation”
- explaining that since plaintiff had the burden of proof, “[they] must make a showing sufficient to establish the existence of every element essential to [their] case” (citations omitted)
- noting that pro se parties “cannot flout procedural rules— they must abide by the same rules that apply to all other litigants”

## Opinion text

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

TYRIN GAYLE, :
Plaintiff : No. 1:23-cv-00861
:
v. : (Judge Kane)
:
S. MOWATT, MD, et al., :
Defendants :

MEMORANDUM

Currently before the Court is Defendants’ motion to dismiss pro se Plaintiff’s amended
complaint or, in the alternative, motion for summary judgment. For the reasons stated below, the
Court will grant the motion to dismiss, dismiss Plaintiff’s amended complaint for lack of subject-
matter jurisdiction and for the failure to state a plausible claim for relief, and not provide
Plaintiff with leave to file a second amended complaint. The Court will also deny the motion for
summary judgment as moot and direct the Clerk of Court to close this case.
I. BACKGROUND
Pro se Plaintiff Tyrin Gayle (“Gayle”), a convicted and sentenced federal prisoner,
commenced this action by filing a complaint, an application for leave to proceed in forma
pauperis (“IFP Application”), and certified prisoner trust fund account statement, all of which the
Clerk of Court docketed on May 24, 2023. See (Doc. Nos. 1–3). In the complaint, Gayle
asserted claims for violations of his First and Eight Amendment rights under Bivens v. Six
Unknown Named Agents of Federal Bureau of Narcotics, 403 U.S. 388 (1971) and state-law
claims for negligence under the Federal Tort Claims Act (“FTCA”) against Defendants United
States of America (the “Government”), S. Mowatt, M.D. (“Dr. Mowatt”), Rhea Carey, PA-C
(“Carey”), John Keelen, CRNP (“Keelen”), Ann Narcoonis, APN (“Narcoonis”), and Jeremy
Simonson, Health Service Assistant (“Simonson”). See (Doc. No. 1 at 1–3).
On July 11, 2023, the Court issued a Memorandum and Order which, inter alia, granted
the IFP Application, dismissed the complaint, and provided Gayle with leave of Court to file an
amended complaint within thirty (30) days. See (Doc. Nos. 6, 7). After receiving an extension
of time (Doc. Nos. 8, 9), Gayle timely filed an amended complaint on September 6, 2023, along
with separately docketed exhibits.1 (Doc. Nos. 11, 12). Regarding the named Defendants and

the causes of action in the amended complaint, Gayle names the same six (6) Defendants he
named in his original complaint; however, he indicates that he is no longer asserting an FTCA
claim or Bivens claims for violations of the First Amendment. (Doc. No. 11 at 1–3). Instead, he
indicates that he asserts only Bivens claims for alleged violations of his rights under the Eighth
and Fourteenth Amendments. (Id. at 1, 10). For relief, Gayle requests an injunction “for an
effective treatment to diagnosis [sic] seizure disorder, that is, long-term, ambulatory, video EEG
monitoring and a clinical correlation is requested” with a doctor, as well as monetary damages.
See (id. at 10).
Concerning his factual allegations, Gayle describes events that allegedly occurred

between late-August 2019 through early-March 2023 while he was incarcerated at United States
Penitentiary Canaan (“USP Canaan”).2 (Id. at 4–10). Gayle’s allegations start with a medical
visit he had with Carey at USP Canaan’s Health Services on August 28, 2019. (Id. at 5). During
this visit, Gayle informed Carey that he had experienced seizures following a motor vehicle
accident in 2015, and he had two (2) “episodes” earlier that day. (Id.) Based on her evaluation,
Carey assessed Gayle as having “Epilepsy/Seizure Disorder,” and he was prescribed 100 mg

1 Gayle submitted his medical records as exhibits. (Doc. No. 12.) Most of Gayle’s allegations
in his amended complaint are purported summaries of the contents in those medical records.
(Doc. No. 11 at 5–8.)

2 Gayle is currently incarcerated at Federal Correctional Institution McKean.
“Phenytoin Sodium ER Capsule” to take three (3) times per day. See (id. at 5; Doc. No. 12 at 2).
In addition, lab tests and an on-site CT Scan were ordered. See (Doc. No. 12 at 2).
The following day, Gayle appeared at the pill line looking for medications. See (Doc.
Nos. 11 at 5; Doc. No. 12 at 4). A Federal Bureau of Prisons (“BOP”) Health Services Clinical

Encounter Administrative Note from Tom Horeis, PharmD (“Dr. Horeis”), states that Gayle had
not picked up his medication the prior evening, i.e. after Carey had prescribed Phenytoin to him.
See (Doc. No. 12 at 4). Dr. Horeis issued Gayle’s medication to him; however, Gayle indicated
that “he was not interested in taking any medication until he knew for sure” what his diagnosis
was. See (id.). Although Dr. Horeis explained to Gayle that he was prescribed Phenytoin as a
preventative measure, and that Gayle had a follow-up appointment scheduled, Gayle “continued
to advise that he was not interested in taking a medication regularly unless he had a test or
something of that sort to define his [diagnosis].” See (id.).3 Dr. Horeis urged Gayle to “walk
over to sick call to verify [his] follow up and to talk a little more about the medications.” See
(id.). Dr. Horeis noted that when the pill line concluded, Gayle was no longer in the room. See

(id.). Dr. Horeis also noted that he would attempt to place Gayle on “call out for tomorrow.”
See (id.).
On the same date, Gayle had a CT Scan of his brain without contrast performed. (Id. at
5; Doc. No. 11 at 5.) The report from the scan, issued by Phyllis Kapellen, M.D., stated that
Gayle’s scan was “[u]nremarkable.” See (Doc. No. 12 at 5).

3 Gayle’s medical records contain numerous abbreviations for terms that are not defined therein.
Where possible, the Court has identified the terms for the abbreviations through Taber’s Medical
Dictionary Online, available at: https://www.tabers.com/tabersonline, and replaced the
abbreviations with the terms in the quoted material from the medical records.
Approximately three-and-a-half (3 ½) months later, on December 9, 2019, Gayle met
with Dr. Mowatt at Health Services for the Chronic Care Clinic. (Id. at 6; Doc. No. 11 at 4.) Dr.
Mowatt’s notes from this visit reflect that Gayle told her that since his motor vehicle accident in
2015, he periodically had episodes “where he bites his tongue, does not remember, [and] feels

tired and confused.” See (Doc. No. 12 at 6). Dr. Mowatt notes that Gayle was scheduled to have
an EEG, and since Gayle had “not really been taking the medication regularly,” she wanted him
to hold off his medications and “get testing while off [AED]4 to see if abnormal or not.” See
(id.; Doc. No. 11 at 5); see also (Doc. No. 11 at 4 (alleging that Dr. Mowatt discontinued
medication and ordered testing “because of [Gayle’s] desire not to take medication if[,] as the
staff says[,] that [he] does not have seizures”)). Dr. Mowatt also indicates Gayle agreed with her
plan and was sleeping on the low bunk. (Doc. No. 12 at 6.)
Gayle was evaluated by John Veina, NREMT-P (“Veina”), at Health Services on
December 23, 2019, because he “reportedly” had two (2) seizures that day and bit the tip of his
tongue. See (id. at 8; Doc. No. 11 at 5). Veina’s administrative notes from this encounter

indicate that Veina spoke to the “Doctor via phone and she stated to start [Gayle] back on his
Phenytoin ER 100 MG Cap. 1 Tablet 3 times daily and to be placed on pill line.” See (Doc. No.
12 at 8). Apparently, this was done “without approval from Gayle.” See (Doc. No. 11 at 5).

4 AED refers to an “antiepileptic drug.” See AED, Taber’s Medical Dictionary Online,
https://www.tabers.com/tabersonline (last visited February 7, 2025). Later in his complaint,
Gayle appears to believe that “AED” refers to an automated external defibrillator. See (Doc. No.
11 at 6 (“Gayle approached Dr. Mowatt while he was in Health Services, questioning why he is
no longer on AED [Automated External Defibrillator] . . . .”). It is highly unlikely that Gayle is
correct insofar as an automated external defibrillator “is a portable device that can be used to
treat a person whose heart has suddenly stopped working.” See Mayo Clinic, Automated
External Defibrillators: Do You Need an AED? (last visited February 7, 2025).
On January 3, 2020, Gayle had a follow-up visit at Health Services. (Id.; Doc. No. 12 at
10.) The administrative notes from this visit indicate that, inter alia, Gayle (1) had not had any
seizures since his last episode, (2) recently restarted on Dilantin to treat his seizures, (3) missed
his morning dose of Dilantin, (4) was unhappy about having to take medication for his seizures,

and (5) had an EEG that was “pending to be scheduled.” See (id. at 10–11; Doc. No. 11 at 5).
The notes also state that Gayle “[n]eed[ed r]einforcement” regarding taking his medications. See
(Doc. No. 12 at 11).
Gayle underwent an EEG on January 27, 2020. (Id. at 12; Doc. No. 11 at 5). Vithalbhai
D. Dhaduk, M.D. (“Dr. Dhaduk”) issued a report from the EEG, which provides the following
impression: “THIS IS A NORMAL EEG RECORDING WITH NO EVIDENCE OF
EPILEPTIGENIC ACTIVITY SEEN. SIMULTANEOUSLY EKG RECORDING REVEALS
NO CARDIAC ARRHYTHMIAS.” See (Doc. No. 12 at 12). Dr. Dhaduk’s report also indicates
that “IF CLINICALLY SUSPECTED TRUE SEIZURE DISORDER, ONE MAY CONSIDER
LONG-TERM, AMBULATORY, VIDEO EEG MONITORING. CLINICAL CORRELATION

IS REQUESTED.” See (id.; Doc. No. 11 at 5). Gayle alleges that Dr. Dhaduk told him during
this appointment that he “should not take any kind of medications until [he] was truely [sic]
diagnosed to have seizures.” See (Doc. No. 11 at 8).
A follow-up visit at Health Services occurred on February 7, 2020. (Id. at 6; Doc. No. 12
at 13.) The administrative notes from this visit indicate that Gayle reported that he had not
recently taken the Dilantin as prescribed “because [the] neurologist told him he did not need to
take [it].” See (Doc. Nos. 11 at 6; 12 at 13). The notes also show that Health Services did not
have any documentation yet relating to Gayle’s visit with neurology and the EEG on January 27,
2020. See (Doc. No. 12 at 13).
Health Services reviewed Dr. Dhaduk’s report from Gayle’s January 27, 2020 EEG on
February 10, 2020. (Id. at 16; Doc. No. 11 at 6.) The administrative notes from this review
reflect that Health Services was aware that the EEG “was normal with no evidence of
epileptogenic activity seen” and Gayle “was non[-]compliant with Dilantin during that time and

Dilantin level subtherapeutic.” See (Doc. Nos. 11 at 6; 12 at 16). The notes also indicate that
the plan was to follow up with Gayle in clinic to discuss the EEG results and discontinuing his
prescription for Dilantin. (Doc. Nos. 11 at 6; 12 at 16.)
A month later, on March 10, 2020, Gayle had a follow-up visit at Health Services in
which they discussed his EEG results, which “did not indicate epileptic focus” and were within
normal limits. (Doc. Nos. 11 at 6; 12 at 17.) The administrative notes from this visit indicate
that, according to a discussion with Gayle, “he does not have grand mal type seizures, but [a
series of] focal seizures (staring amnesia).” See (Doc. No. 12 at 17). The notes also show that
Gayle had been non[-]complaint with regularly taking Dilantin. (Id.) The notes further state that
Gayle’s case was discussed with the doctor, and due to Gayle’s normal EEG and Dilantin level

subtherapeutic, they were discontinuing Gayle’s prescription for Dilantin and his low bunk pass.
(Id.) Gayle was to follow up as needed, and the notes show that Gayle was “agreeable with [this]
plan.” See (id.).
The next day, Dr. Mowatt prepared an administrative note stating that Gayle had
approached her while they were both in Health Services that morning. (Doc. Nos. 11 at 6; 12 at
20.) Her note indicates as follows:
[A]pproached by [Gayle] while he was in health services this am[. H]e is
questioning why he is no longer on AED[. I] explained his EEG was normal[,] he
was non[-]compliant with his medications and now noted no need for AED. He
states he is still having episodes, he was never on medication prior[,] and now he
wa[n]ts to take chronically. We will continue to follow. He then asked who is
above me in the department, I explained I am the only physician, he was welcome
to speak with HSA if he wanted. He then left the department.

See (Doc. No. 12 at 20). Gayle avers that the “HSA” or “Health Services Assistant,” was
Simonson. (Doc. No. 11 at 6).
Dr. Mowatt also prepared an administrative note dated March 24, 2020, pertaining to a
Chart Review she performed relating to Gayle. (Id.; Doc. No. 12 at 21.) This note states:
[Gayle] was never diagnosed with seizure disorder prior to being here as [USP
Canaan. H]e reported staring spells being out of it that followed a [motor vehicle
accident] from years ago[. H]e was empirically started on medication but was non[-
]compliant. He was sent out for EEG that did not show epileptiform waves. Since
then he [complains of] frequent seizures and now biting his tongue?? No criteria
to place on medication at this time. Normal CT head and EEG within the last year.

See (Doc. No. 12 at 21).
Gayle was next evaluated at Health Services on April 26, 2020. (Id. at 22; Doc. No. 11 at
6.) The administrative note for this visit indicates as follows:
C-1 unit officer contacted medical regarding . . . Gayle . . ., who stated that he “had
a seizure.” [Gayle] never hit the duress alarm, but told the officers on rounds that
he has been having seizures “all weekend long” and “remembers having them.”
[Gayle] was sent to [Health Services] where he was evaluated. Upon reviewing
previous documentation, [Gayle] was recently spoken to by the acting clinical
director regarding a normal EEG and head CT, which is why his AED were
discontinued. When [Gayle] arrived [Health Services] he became argumentative
stating “I know I’m having seizures, I remember having them and my cellie tells
me.” Health services staff told . . . Gayle during this encounter that he did not have
postictal signs as well as about his normal CT/EEG. At which time he became even
more agitated and verbally aggressive towards medical staff. [Gayle] was advised
that he could speak with the HAS should he have any further concerns specific to
this topic, and based on his level of agitation and swearing at staff, that he should
leave the department at this time.

See (Doc. No. 12 at 22).
Gayle appeared at Health Services for a clinical encounter on June 18, 2020, after his unit
officer reported that he “was acting ‘[s]paced out.’” See (id. at 24; Doc. No. 11 at 6). The
administrative notes for this visit reflect that Gayle walked to Health services “unassisted.” See
(Doc. No. 12 at 24). While there, Gayle indicated that “he thinks he had a seizure because he
woke up and he had bit his tongue,” “he is having regular seizures though not frequently,” and
“his seizures ‘[p]lay with [his] memory.’” See (id.). The nurse who examined Gayle pointed out
that Gayle was “sluggish to respond at times.” See (id.). The nurse’s assessment states that

Gayle’s behavior was “[a]ltered,” that it was “[u]nclear at this time if [his] seizure claims are
substantiated,” and that he was stable with “[n]o obvious life-threatening illness or injuries
noted.” See (id.). The nurse also indicates that Gayle had a minor injury to the tip of his tongue.
(Id.)
Dr. Mowatt also examined Gayle that day, and she noted that Gayle told her that he was
“convinced he was having seizures.” See (id. at 26; Doc. No. 11 at 6). Dr. Mowatt pointed out
that when they told Gayle to take medication, he had refused, and he also had a normal EEG and
CT scan. (Doc. No. 12 at 26). When Dr. Mowatt asked Gayle what he wanted, Gayle told her
that he wanted to know what was happening to him, and he stated he has memory issues and
bites his tongue. (Id.) Dr. Mowatt placed a request for Neurology to evaluate Gayle, and she

indicated that Gayle would get another EEG along with a “sleep deprivation and neuro consult.”
See (id.).
Veina saw Gayle again on August 8, 2020. (Id. at 28; Doc. No. 11 at 7.) Veina’s notes
from this visit reflect that the unit officer called him to see Gayle because Gayle claimed he had
a seizure. (Doc. No. 12 at 28.) Those notes also indicate that Gayle was claiming that he was
having seizures, even though “it [sic] was unwitnessed.” See (id.). Gayle also claimed he had
“one about an hour ago,” even though Veina observed that Gayle “showed no [signs and
symptoms] of being postictal.” See (id.). Veina reviewed Gayle’s vitals and found them to be
within normal limits. See (id.). Gayle was released back to his housing unit and was advised
that he would be scheduled with a provider for a follow-up. (Id.)
The next event described in the amended complaint did not occur until December 2,
2020, when Dr. Sanjay Sood (“Dr. Sood”) evaluated Gayle in his housing unit. (Id. at 30; Doc.

No. 11 at 7.) Dr. Sood’s notes from this visit indicate that Gayle “notes [an] episode of seizure
with lip biting; he had previous work up by neurology regarding seizures [which were]
determined to be negative.” See (Doc. No. 12 at 30).5 Dr. Sood’s exam comments state: “inner
upper lip with erosion.” See (id.). His plan was to, inter alia, schedule a consultation for Gayle
with Neurology (off-site) to evaluate Gayle for “Petit Mal or Partial Complex Seizures” due to
“Gayle report[ing] episodes of ‘black outs’ followed by lip biting (lip wound noted).” See (id. at
31).
More than six (6) months later, on May 25, 2021, Veina went to Gayle’s cell in response
to a call for a medical emergency, after the “Unit Officer reported that [Gayle’s] cellmate came
to the Officer station and reported that [Gayle] was having a seizure[, and the] Officer reported

that when he got . . . to [the] cell he found [Gayle] laying on the cell floor with his head shaking
from side to side.” See (id. at 32–33; Doc. No. 11 at 7). Veina’s clinical encounter notes
indicate that when he arrived less than two (2) minutes after the call, Gayle was standing outside
his cell and reported to Veina that he just had a seizure. (Doc. No. 12 at 33.) Veina and Gayle
then proceeded to go to “medical,” with Veina noting that Gayle “walked from [h]is cell down
the stairs and to medical without assistance with a normal gait.” See (id.). Viena’s notes show
that Gayle’s vitals were examined and appeared to be within normal limits. (Id.) Gayle also

5 Dr. Sood’s administrative notes show that he also evaluated Gayle for right knee pain. (Doc.
No. 12 at 30.) The Court has not referenced any notes relating to that evaluation because there is
no indication that the knee pain was related to any seizures.
stated that he did not recall what occurred, but he knew he had a seizure because he bit his lip.
(Id.) Viena remarks in his notes that Gayle had a mark on his lower lip where it appeared that he
bit his lip. (Id.)
On June 27, 2021, a triage note was prepared after an encounter with Gayle at Health

Services. (Id. at 34; Doc. No. 11 at 7.) The note shows that a unit officer contacted Health
Services after Gayle’s cellmate said Gayle had a seizure that was not witnessed by staff. (Doc.
No. 12 at 34, 35.) The note also indicates that Gayle “was able to walk immediately to Medical
from [the] housing unit without difficulty or confusion,” “was immediately able to answer
questions appropriately,” “denie[d] any pain,” and “denie[d] any recent seizure activity.” See
(id. at 35).
Gayle had a follow-up visit with Keelen at Health Services on September 13, 2021. See
(id. at 37; Doc. No. 11 at 7). Keelen’s notes from this visit indicate that it was scheduled due to
Gayle’s left-hand splint and scheduled orthopedic appointment. (Doc. No. 12 at 37.) The notes
also state that Gayle was noncompliant with the use of the splint and was “more concerned about

[an] EEG that was canceled due to none [sic] compliance with medication and [his] last EEG
[was within normal limits].” See (id.). Keelen reports that he “explained to [Gayle that] he has
not dropped a cop out to [him] about seizers [sic] or has not had a medical emergency . . . since
[Keelen has] been here.” See (id.).
Gayle avers that he next visited Health Services for a sick call encounter on January 31,
2022. (Id. at 39; Doc. No. 11 at 7.) Keelen prepared notes from this visit indicating that Gayle
had filled out a sick call due to an unwitnessed seizure. (Doc. No. 12 at 39.) Keelen also states
that Gayle “had a history of having unwitnessed seizures” and “has not been post-ictal [sic].”
See (id.). Keelen reports that he explained to Gayle that he did not have a seizure disorder. See
(id.). Keelen’s exam showed no “abnormal findings.” See (id. at 40). However, Gayle alleges
that he insisted to Keelen that he had a seizure, which “agitated” Keelen to the point where he
called Gayle a liar and kicked him out of the room while yelling, “You don’t have seizures!”
See (Doc. No. 11 at 8).

On May 6, 2022, Narcoonis conducted an injury assessment of Gayle at the Special
Housing Unit (“SHU”). (Id. at 7; Doc. No. 12 at 41.) Narcoonis’s notes from this assessment
indicate that Gayle reported that he “fell to the ground during his seizure and bit his lip” and was
experiencing “headache, [a] bloody lip, muscle weakness, [and] confusion.” See (Doc. No. 12 at
41). Narcoonis also noted that an unidentified Operations Lieutenant suspected that Gayle had
used an “illicit substance.” See (id.). As for her assessment, Narcoonis stated as follows:
Suspected Drug Usage

[Gayle] was observed by staff as lethargic and slow to respond in housing unit.
Officer report [sic] “[Gayle] acting strangely in housing unit.” Escorted to medical
for evaluation. Evaluation completed by Baron Paramedic to assess a possible
seizure. It was determined that [Gayle] did not have a seizure on the housing unit
and does not have a history of testing which would indicate the diagnosis of a
seizure.

This writer saw [Gayle] in SHU for medical evaluation due to change in mental
status, as requested by Op [sic] Lt. Gait unsteady at times. Pupils dilated to 3 mm,
equal[,] however sluggish to light. [E]yes somewhat watery/glossy. [A]ffect flat.
[B]ody mechanics + rigid.

[R]eported by Op [sic] Lt. that Visual [sic] hallucinations were present. [G]rabbing
an object not present. This provider was not witness to [visual hallucinations].
[S]low to respon[d] to . . . questions. [N]o evidence of burn marks on fingers.

[Complains of] headache. [D]enies current [nausea or vomiting]. [D]enies
[shortness of breath]. [Gayle] denies any drug use.

Review of [Gayle’s] medical records does not indicate any current medication or
medical condition which would be contributory to [his] current status. Last EEG
reviewed-normal results. [N]ot currently prescribed any seizure medication
although [Gayle] reports he is prescribed medication for seizures. Medical
determination = [Gayle’s] behavior/current status is not related to any current
medication condition and is most likely congruent with use of an illicit substance.

See (id. at 41–42).
Along with identifying the information in Narcoonis’s report, Gayle alleges that she “put
[him] in the SHU.” See (Doc. No. 11 at 8).6 Gayle complains that Narcoonis “had no reason” to
have him sent to the SHU and falsely accused him of using illicit substances. See (id.). Gayle
avers that he does not use drugs. (Id.) Apparently, this incident resulted in Gayle being locked
up in disciplinary segregation for thirty (30) days and the imposition of several sanctions. (Id.).
Approximately ten (10) days after his visit with Narcoonis, Gayle had a follow-up visit
with Keelen at the SHU relating to his complaint of a seizure. (Id. at 7; Doc. No. 12 at 43.)
Keelen’s notes from this visit indicate that Gayle “has a [history] of saying he has [seizures] but
no medical evidence of [seizures]” and “state[d] that he does not take any [medications].” See
(Doc. No. 12 at 43). Keelen also indicates that he examined Gayle and reported no abnormal
findings. See (id.). Gayle alleges that Keelen told him that he could not “exclude[] that
[Gayle’s] seizures were self[-]inflicted verse [sic] external trama [sic].” See (Doc. No. 11 at 8).
Gayle believes that Keelen was accusing him of being a liar by faking seizures. (Id.)
On September 13, 2022, Carey prepared an administrative note based on her review of
paramedic findings from an exam of Gayle. (Id. at 7; Doc. No. 12 at 45.) Carey’s note stated as
follows:

[C]alled in to review paramedic findings from exam. [Vital signs stable]. [B]enign
exam except for swelling and abrasion to the inner upper lip. [E]xamined by dental
and found to be inconsistent with biting, cannot exclude self[-]inflicted vs[.]

6 In support of this allegation, Gayle purports to cite to an “Incident Report,” see (id.), however,
no such report is attached to his amended complaint or included among his separately filed
exhibits. It is also unclear how Narcoonis, a member of USP Canaan’s medical staff, could have
placed Gayle in disciplinary segregation because such decisions are typically made by
corrections staff.
external trauma. [R]eferred to the LT for questioning. [N]o real seizure activity
witnessed. [Gayle] did attempt to feign a seizure while dental performed their
exam. [CT] scan of the brain and multiple EEG unremarkable. [Gayle] medically
cleared to return to his housing unit pending LT’s decision.

See (Doc. No. 12 at 45).
The next event in Gayle’s amended complaint occurred on January 24, 2023, when Veina
evaluated Gayle at Health Services. (Id. at 46; Doc. No. 11 at 8.) Veina’s notes from this visit
indicate that Gayle had reported multiple seizures the prior day. (Doc. No. 12 at 46.) Those
notes also indicate that Veina’s exam found that Gayle’s vitals were within normal limits, and he
had “a small abrasion on the inside of his upper lip.” See (id. at 47).
On February 15, 2023, a chart review was performed by Dr. Diane Sommer at
“Telehealth” due to Gayle filing a BP-8 form.7 See (Doc. Nos. 11 at 8; 12 at 48). Dr. Sommer’s
notes reflect that she ordered a consultation with neurology so Gayle could be evaluated for
possible seizures. (Doc. No. 12 at 48.) She also noted that Gayle “insists he has seizures even
though staff never witness [them],” “has a negative head ct scan,” has a “neg[ative] EEG,”
“refuses medication,” “bites the[]inside of his mouth,” and “never looses [sic] urine.” See (id.).
The final medical visit (and event) Gayle describes in his amended complaint is his visit
with Carey at Health Services on March 8, 2023. (Id. at 49–50; Doc. No. 11 at 8, 9.) Carey’s
notes from this visit show that she checked his blood pressure due to it being elevated at his last
encounter. (Doc. No. 12 at 49.) Carey indicates that Gayle did not offer any new complaints,
and she rescheduled him for an additional check in a few months. (Id.) Although Carey’s

7 The filing of a BP-8 form is the first step in the BOP’s administrative grievance process. See
28 C.F.R. § 542.13 (“[A]n inmate shall first present an issue of concern informally to staff, and
staff shall attempt to informally resolve the issue before an inmate submits a Request for
Administrative Remedy.”); Stanton v. Paul, No. 22-cv-00647, 2024 WL 1916696, at *6 (M.D.
Pa. May 1, 2024) (“Before seeking formal review, an inmate must attempt to informally resolve
the issue with institutional staff by completing a BP-8 form.” (citing 28 C.F.R. § 542.13)).
medical notes do not indicate this, Gayle alleges that Carey “gave [him] medication without
daignosis [sic] of seizures . . . to validate medical treatment medication use.” See (Doc. No. 11
at 9). Gayle also avers that “[t]his also clearly showed [him] that the staff/defendants were
indifferent to [his] treatment based on [his] concerns and complaints of not wanting to take

medication as [Dr. Dhaduk] advised [him].” See (id.).
After reviewing the amended complaint, this Court issued an Order on October 25, 2023,
directing the United States Marshals to serve the amended complaint on the Government, and the
Clerk’s Office to send waiver of service forms to Defendants. (Doc. No. 13.) The individual
Defendants waived service, and all Defendants filed the instant motions to dismiss the amended
complaint or, in the alternative, for summary judgment on January 5, 2024. (Doc. No. 19.) After
receiving an extension of time to file their supporting brief and statement of material facts in
support of their motion for summary judgment, Defendants filed both documents on January 19,
2024. (Doc. Nos. 23, 24.) Although Gayle indicated that he was in the process of filing a
response to Defendants’ motions via a letter dated September 24, 2024 (Doc. No. 27), he has

never filed a response to date. Thus, Defendants’ motions are ripe for disposition.
II. LEGAL STANDARDS
A. Motions to Dismiss Under Rule 12(b)(1)
“A challenge to subject matter jurisdiction under Rule 12(b)(1) may be either a facial or a
factual attack.” Davis v. Wells Fargo, 824 F.3d 333, 346 (3d Cir. 2016). “A court ruling on a
facial attack considers only the complaint, viewing it in the light most favorable to the plaintiff.”
Long v. SEPTA, 903 F.3d 312, 320 (3d Cir. 2018) (citation omitted). However, a court ruling on
a factual attack, wherein the defendant contests the truth of the jurisdictional allegations, “is a
different matter: the court need not treat the allegations as true[.]” See id. (citations omitted).
“In reviewing a factual attack, the court may consider evidence outside the pleadings.” Gould
Elecs. Inc. v. United States, 220 F.3d 169, 176 (3d Cir. 2000) (citation omitted). Indeed,
“[b]ecause at issue in a factual 12(b)(1) motion is the trial court’s . . . very power to hear the
case[,] there is substantial authority that the trial court is free to weigh the evidence and satisfy

itself as to the existence of its power to hear the case.” See Mortensen v. First Fed. Sav. & Loan
Ass’n, 549 F.2d 884, 891 (3d Cir. 1977). In other words, “no presumptive truthfulness attaches
to plaintiff’s allegations, and the existence of disputed material facts will not preclude the trial
court from evaluating for itself the merits of jurisdictional claims.” See id.
B. Motions to Dismiss Under Rule 12(b)(6)
Federal notice and pleading rules require the complaint to provide the defendant with
notice of the claim and the grounds upon which it rests. See Phillips v. County of Allegheny,
515 F.3d 224, 232 (3d Cir. 2008). The plaintiff must present facts that, accepted as true,
demonstrate a plausible right to relief. See Fed. R. Civ. P. 8(a). Although this requires a
complaint to consist of “only a short and plain statement of the claim showing that the pleader is

entitled to relief,” see Fed. R. Civ. P. 8(a)(2), a complaint may nevertheless be dismissed under
Federal Rule of Civil Procedure 12(b)(6) for “failure to state a claim upon which relief can be
granted.” See Fed. R. Civ. P. 12(b)(6).
When ruling on a motion to dismiss under Rule 12(b)(6), the Court must accept as true all
factual allegations in the complaint and all reasonable inferences that can be drawn from them,
viewed in the light most favorable to the plaintiff. See In re Ins. Brokerage Antitrust Litig., 618
F.3d 300, 312 (3d Cir. 2010). The Court’s inquiry is guided by the standards of Bell Atlantic
Corp. v. Twombly, 550 U.S. 544 (2007), and Ashcroft v. Iqbal, 556 U.S. 662 (2009). Under
Twombly and Iqbal, pleading requirements have shifted to a “more heightened form of
pleading.” See Fowler v. UPMC Shadyside, 578 F.3d 203, 210 (3d Cir. 2009). To prevent
dismissal, a complaint must set out “sufficient factual matter” to show that the claims asserted
therein are facially plausible. See id. The plausibility standard requires more than a mere
possibility that the defendant is liable for the alleged misconduct. As the Supreme Court

instructed in Iqbal, “where 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.’” See Iqbal, 556 U.S. at 679 (alteration in original) (quoting Fed. R.
Civ. P. 8(a)(2)).
Accordingly, to determine the sufficiency of a complaint under Twombly and Iqbal, the
district court must: (1) identify the elements a plaintiff must plead to state a claim; (2) identify
any conclusory allegations contained in the complaint “not entitled” to the assumption of truth;
and (3) determine whether any “well-pleaded factual allegations” contained in the complaint
“plausibly give rise to an entitlement to relief.” See Santiago v. Warminster Twp., 629 F.3d 121,
130 (3d Cir. 2010) (quoting Iqbal, 556 U.S. at 679). When following these steps, “a court must

consider only the complaint, exhibits attached to the complaint, matters of public record, as well
as undisputedly authentic documents if the complainant’s claims are based upon these
documents.” See Mayer v. Belichick, 605 F.3d 223, 230 (3d Cir. 2010) (citing Pension Ben.
Guar. Corp. v. White Consol. Indus., Inc., 998 F.2d 1192, 1196 (3d Cir. 1993)).
In addition, in the specific context of pro se prisoner litigation, the Court must be mindful
that a document filed pro se is “to be liberally construed.” See Estelle v. Gamble, 429 U.S. 97,
106 (1976); Higgs v. Att’y Gen., 655 F.3d 333, 339–40 (3d Cir. 2011) (explaining that “when
presented with a pro se litigant, we have a special obligation to construe his complaint liberally”
(citation and internal quotation marks omitted)). Therefore, a pro se complaint, “however
inartfully pleaded,” must be held to “less stringent standards than formal pleadings drafted by
lawyers.” See Erickson v. Pardus, 551 U.S. 89, 94 (2007) (internal quotation marks omitted)
(quoting Estelle, 429 U.S. at 106). This means the court must always “remain flexible,
especially ‘when dealing with imprisoned pro se litigants . . . .’” See Vogt v. Wetzel, 8 F.4th

182, 185 (3d Cir. 2021) (quoting Mala v. Crown Bay Marina, Inc., 704 F.3d 239, 244–45 (3d
Cir. 2013)). Additionally, when construing a pro se complaint, the court will “apply the relevant
legal principle even when the complaint has failed to name it.” See Mala, 704 F.3d at 244.
However, pro se litigants “cannot flout procedural rules—they must abide by the same rules that
apply to all other litigants.” See id. at 245.
C. Motions for Summary Judgment
The Court must render summary judgment “if the movant shows that there is no genuine
dispute as to any material fact and the movant is entitled to judgment as a matter of law.” See
Fed. R. Civ. P. 56(a). “[T]his standard provides that the mere existence of some alleged factual
dispute between the parties will not defeat an otherwise properly supported motion for summary

judgment; the requirement is that there be no genuine issue of material fact.” Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 247–48 (1986). A disputed fact is “material” if proof of its
existence or nonexistence would affect the outcome of the case under applicable substantive law.
See id. at 248; Gray v. York Newspapers, Inc., 957 F.2d 1070, 1078 (3d Cir. 1992). A dispute of
material fact is “genuine” if “the evidence is such that a reasonable jury could return a verdict for
the nonmoving party.” See Anderson, 477 U.S. at 257. When determining whether there is a
genuine dispute of material fact, the Court must view the facts and all reasonable inferences in
favor of the nonmoving party. See id. at 255 (“The evidence of the non-movant is to be
believed, and all justifiable inferences are to be drawn in [their] favor.”).
To avoid summary judgment, the nonmoving party may not rest on the unsubstantiated
allegations of their pleadings. As such, when the party seeking summary judgment satisfies their
burden to demonstrate the absence of a genuine dispute of material fact, the burden of production
shifts to the nonmoving party, who must “go beyond the pleadings” with affidavits, “depositions,

answers to interrogatories, and the like” to show specific material facts giving rise to a genuine
dispute. See Celotex Corp. v. Catrett, 477 U.S. 317, 324 (1986); id. at 328 (White, J.,
concurring). The nonmoving party “must do more than simply show that there is some
metaphysical doubt as to the material facts.” See Matsushita Elec. Indus. Co. v. Zenith Radio
Corp., 475 U.S. 574, 586 (1986) (citation omitted). Instead, they must produce evidence to show
the existence of every element essential to their case that they bear the burden of proving at trial,
for “a complete failure of proof concerning an essential element of the nonmoving party’s case
necessarily renders all other facts immaterial.” See Celotex Corp., 477 U.S. at 323; see also
Harter v. GAF Corp., 967 F.2d 846, 852 (3d Cir. 1992) (explaining that since plaintiff had the
burden of proof, “[they] must make a showing sufficient to establish the existence of every

element essential to [their] case” (citations omitted)).
As noted supra, when determining whether a dispute of material fact exists, the Court
must consider the evidence in the light most favorable to the non-moving party. See Matsushita
Elec. Indus. Co., 475 U.S. at 588 (citation omitted). In doing so, the Court must “accept the non-
movant’s allegations as true and resolve any conflicts in [their] favor.” See White v.
Westinghouse Elec. Co., 862 F.2d 56, 59 (3d Cir. 1988), abrogated on other grounds by Hazen
Paper Co. v. Biggins, 507 U.S. 604 (1993). However, a party opposing a summary judgment
motion must comply with Local Rule 56.1, which specifically directs the oppositional party to
submit a “statement of the material facts, responding to the numbered paragraphs set forth in the
statement required [to be filed by the movant], as to which it is contended that there exists a
genuine issue to be tried”; if the nonmovant fails to do so, “[a]ll material facts set forth in the
statement required to be served by the moving party will be deemed to be admitted.” See M.D.
Pa. L.R. 56.1. A party cannot evade these litigation responsibilities in this regard simply by

citing the fact that they are a pro se litigant because these rules apply with equal force to all
parties. See Mala, 704 F.3d at 245 (noting that pro se parties “cannot flout procedural rules—
they must abide by the same rules that apply to all other litigants”).
Even if the Court deems the facts in the moving party’s submission to be admitted due to
the nonmoving party’s failure to comply with Local Rule 56.1, the Court cannot simply grant the
motion for summary judgment as unopposed. Instead, the Court can only grant the motion if the
Court “find[s] that judgment for the moving party is ‘appropriate.’” See Anchorage Assocs. v.
V.I. Bd. of Tax Rev., 922 F.2d 168, 175 (3d Cir. 1990). The analysis for determining whether
judgment is “appropriate” depends on whether the party moving for summary judgment bears the
“burden of proof on the relevant issues”:

Where the moving party has the burden of proof on the relevant issues, this means
that the district court must determine that the facts specified in or in connection
with the motion entitle the moving party to judgment as a matter of law. Where the
moving party does not have the burden of proof on the relevant issues, this means
that the district court must determine that the deficiencies in the opponent’s
evidence designated in or in connection with the motion entitle the moving party to
judgment as a matter of law.

See id. (citing Celotex Corp., 477 U.S. 317).
III. DISCUSSION
In their combined motion, Defendants move for judgment in their favor because Gayle
failed to exhaust his administrative remedies as required by the Prison Litigation Reform Act
(“PLRA”) prior to filing his complaint in this case. (Doc. No. 24 at 24–27.) Defendants also
move to dismiss Gayle’s amended complaint on several grounds. First, Defendants move to
dismiss Gayle’s Bivens claims for violations of his Eighth and Fourteenth Amendment rights
because there are no Bivens remedies for these claims. (Id. at 27–42.) Second, if the Court
determines that there are Bivens remedies for Gayle’s claims, Defendants move for dismissal of

these claims based on conduct occurring prior to May 24, 2021, because the statute of limitations
bars those claims. (Id. at 42–44.) Third, Defendants argue that they are entitled to qualified
immunity because Gayle failed to allege Simonson’s personal involvement in any constitutional
violation and his allegations against the other Defendants consists only of disagreements about
the treatment he received. (Id. at 44–53.) Fourth, and finally, Defendants move for dismissal of
Gayle’s claim against the Government for lack of subject-matter jurisdiction or, alternatively, for
Gayle’s failure to state a claim upon which relief may be granted. (Id. at 53–59.)
As discussed in more detail below, the Court will grant Defendants’ motion to dismiss
Gayle’s Bivens claims for Eighth and Fourteenth Amendment violations because there are no
Bivens remedies for those claims. The Court will also grant Defendants’ motion to dismiss

Gayle’s Bivens claim against the Government because it is immune from such a claim, and deny
Gayle leave of Court to file a second amended complaint.
A. Gayle’s Bivens Claim Against the Government
Although Gayle included a FTCA against the Government in his original complaint, the
Court understands him to have abandoned that claim in his amended complaint. See (Doc. No. 1
at 1 (checking box on form civil rights complaint for Bivens claim but not checking box for
FTCA claim)). Instead, Gayle appears to be asserting a Bivens claim against the United States.
As Defendants argue in their motion, the Government is immune from any Bivens claim Gayle
could attempt to assert against it. Therefore, the Court will grant Defendants’ motion to dismiss
Gayle’s Bivens claim against the Government.
Sovereign immunity constitutes a jurisdictional bar to claims against the United States
and its agencies unless Congress has specifically waived such immunity. See FDIC v. Meyer,

510 U.S. 471, 475 (1994) (“Absent a waiver, sovereign immunity shields the Federal
Government and its agencies from suit. Sovereign immunity is jurisdictional in nature.” (internal
citations omitted)); Lewal v. Ali, 289 F. App’x 515, 516 (3d Cir. 2008) (unpublished) (“An
action against government officials in their official capacities constitutes an action against the
United States [and is] barred by sovereign immunity, absent an explicit waiver.” (citations
omitted)). Similarly, sovereign immunity extends to individual officers acting in their official
capacities, absent an explicit waiver. See Treasurer of N.J. v. U.S. Dep’t of Treasury, 684 F.3d
382, 395 (3d Cir. 2012). Thus, “[w]ithout a waiver of sovereign immunity, a court is without
subject matter jurisdiction over claims against federal agencies or officials in their official
capacities.” See id. (citing United States v. Mitchell, 445 U.S. 535, 538 (1980)). Congress has

not waived the United States and its agencies’ sovereign immunity from Bivens claims. See
Bishop v. U.S. Dep’t of Homeland Sec., 648 F. App’x 180, 181 (3d Cir. 2016) (unpublished)
(“[T]he District Court correctly determined that it lacked jurisdiction over [the plaintiff’s] claims
because the agencies’ sovereign immunity for Bivens claims has not been explicitly waived by
Congress.”). As such, sovereign immunity bars Gayle’s Bivens claims against the Government,
the Court will grant Defendants’ motion to dismiss Gayle’s Bivens claims against the
Government under Rule 12(b)(1) for lack of subject-matter jurisdiction and dismiss these claims
without prejudice. See Lewal, 289 F. App’x at 516 (“Bivens claims against the United States are
barred by sovereign immunity, absent an explicit waiver.”).
Additionally, although the Court understands Gayle to have abandoned any FTCA claim
against the Government in his amended complaint, even if he did not do so, the Government
would still be immune from any FTCA claim based on the allegations in the amended complaint.
The FTCA is a limited waiver of sovereign immunity and authorizes suits against the United

States:
for injury or loss of property, or personal injury or death caused by the negligent or
wrongful act or omission of any employee of the Government while acting within
the scope of his office or employment, under circumstances where the United
States, if a private person, would be liable to the claimant in accordance with the
law of the place where the act or omission occurred.

See 28 U.S.C. § 1346(b)(1). Essentially, the FTCA renders the United States “liable to the same
extent as a private party for certain torts committed by federal employees acting within the scope
of their employment.” See United States v. Orleans, 425 U.S. 807, 813 (1976).
The FTCA “does not itself create a substantive cause of action against the United States;
rather, it provides a mechanism for bringing a state law tort action against the federal
government in federal court.” See In re Orthopedic Bone Screw Prod. Liab. Litig., 264 F.3d 344,
362 (3d Cir. 2001). “The FTCA only waives sovereign immunity for torts recognized under the
law of the state in which the conduct was alleged to have occurred.” Rinaldi v. United States,
904 F.3d 257, 272 n.15 (3d Cir. 2018); see also Meyer, 510 U.S. at 478 (explaining that the “law
of the State” is “the source of substantive liability under the FTCA”).
As relevant here, a plaintiff must comply with the FTCA’s jurisdictional requirements,
which are contained in 28 U.S.C. § 2675(a), before filing a FTCA claim in federal court. Section
2675(a) provides that “[a]n action shall not be instituted upon a claim against the United States ...
unless the claimant shall have first presented the claim to the appropriate Federal agency and
[their] claim shall have been finally denied by the agency.” See 28 U.S.C. § 2675(a); see also
Shelton v. Bledsoe, 775 F.3d 554, 569 (3d Cir. 2015) (“No claim can be brought under the FTCA
unless the plaintiff first presents the claim to the appropriate federal agency and the agency
renders a final decision on the claim.”). Thus, “[t]he FTCA contains a jurisdictional bar that
requires a plaintiff to file [their] claim with the appropriate federal agency and receive a final

denial by that agency before filing a complaint in federal court.” See Banks v. Roberts, 251 F.
App’x 774, 776 (3d Cir. 2007) (unpublished) (emphasis added) (citing 28 U.S.C. § 2675(a)); see
also Kucera v. United States, No. 21-2133, 2022 WL 1112985, at *2 (10th Cir. Apr. 14, 2022)
(unpublished) (affirming district court’s dismissal of FTCA claim for lack of subject-matter
jurisdiction because plaintiff did not demonstrate that “the agency had finally denied that claim
before she filed this action”). A plaintiff's “[f]ail[ure] to follow this procedure deprives federal
courts of subject matter jurisdiction.” See Abulkhair v. Bush, 413 F. App’x 502, 506 (3d Cir.
2011) (unpublished) (citing White-Squire v. USPS, 592 F.3d 453, 456–58 (3d Cir. 2010)).
Furthermore, this exhaustion requirement cannot be waived. See Roma v. United States, 344
F.3d 352, 362 (3d Cir. 2003) (“In light of the clear, mandatory language of the statute, and [the]

strict construction of the limited waiver of sovereign immunity by the United States, . . . the
requirement that the appropriate federal agency act on a claim before suit can be brought is
jurisdictional and cannot be waived.” (citing Livera v. First Nat’1 Bank of N.J., 879 F.2d 1186,
1194 (3d Cir. 1989))).
The plaintiff “must plead administrative exhaustion in an FTCA case.” See Guilford v.
FCI Williamsburg, No. 22-cv-01945, 2022 WL 2192945, at *2 (E.D. Pa. June 16, 2022)
(omission omitted) (quoting Colbert v. U.S. Postal Serv., 831 F. Supp. 2d 240, 243 (D.D.C.
2011)). In addition, the plaintiff “carries the burden of proof to establish presentment of [their]
claim to [the agency].” See Medina v. City of Phila., 219 F. App’x 169, 172 (3d Cir. 2007)
(unpublished); see also Lincoln Benefit Life Co. v. AEI Life, LLC, 800 F.3d 99, 105 (3d Cir.
2015) (“The burden of establishing federal jurisdiction rests with the party asserting its
existence.” (citing DaimlerChrysler Corp. v. Cuno, 547 U.S. 332, 342 n.3 (2006))).
Here, Gayle does not allege that he exhausted his administrative remedies with the BOP

regarding any FTCA claim prior to filing his complaint in this case. See (Doc. No. 11 at 1–10).
As such, even if Gayle intended to continue to prosecute a FTCA claim against the Government
in this case, the Court would dismiss such a claim for lack of subject-matter jurisdiction because
Gayle’s allegations are insufficient to show that the Court has jurisdiction over any FTCA claim.
See Burrell v. Loungo, 750 F. App’x 149, 155 (3d Cir. 2018) (unpublished) (affirming district
court’s dismissal of plaintiff’s FTCA claims without prejudice for lack of subject-matter
jurisdiction “[b]ecause the allegations of the complaint were not sufficient to indicate that the
[d]istrict [c]ourt had jurisdiction over [plaintiff’s] FTCA claims”).
B. Eighth Amendment Bivens Claim
Defendants move under Rule 12(b)(6) to dismiss Gayle’s Eighth Amendment deliberate-

indifference-to-serious-medical-needs Bivens claim against them because his allegations present
a new Bivens context and special factors counsel hesitation against granting a Bivens remedy
here. (Doc. No. 25 at 22–30.) For the reasons stated below, the Court agrees with Defendants
and concludes that no Bivens remedy is available for Gayle’s Eighth Amendment claim.
Bivens “provides for private rights of action against federal officials for certain
constitutional violations.” See Bryan v. United States, 913 F.3d 356, 358 n.1 (3d Cir. 2019);
Murphy v. Bloom, 443 F. App’x 668, 669 n.1 (3d Cir. 2011) (unpublished) (“Bivens recognized
a private cause of action to recover damages against federal actors for constitutional violations,
similar to the cause of action against state actors provided by 42 U.S.C. § 1983.”). The Third
Circuit Court of Appeals recently discussed Bivens and the relevant analysis for this Court to
consider and apply when evaluating the viability of a remedy for a plaintiff’s Bivens claim as
follows:
In certain circumstances, the Constitution affords a cause of action for damages
against individual federal officers to redress violations of constitutional rights.
Bivens, 403 U.S. at 397, 91 S.Ct. 1999. “In the case giving the doctrine its name,
the Supreme Court held there is a cause of action for damages when a federal agent,
acting under color of his authority, conducts an unreasonable search and seizure in
violation of the Fourth Amendment.” [Shorter v. United States, 12 F.4th 366, 371
(3d Cir. 2021)] (citing Bivens, 403 U.S. at 389, 397, 91 S.Ct. 1999). In the decade
following Bivens, the Supreme Court recognized two additional causes of action
under the Constitution: first, for a congressional staffer’s gender discrimination
claim under the Fifth Amendment, see Davis v. Passman, 442 U.S. 228, 244, 99
S.Ct. 2264, 60 L.Ed.2d 846 (1979), and second, for a federal prisoner’s inadequate-
care claim under the Eighth Amendment, see [Carlson v. Green, 446 U.S. 14, 19,
100 S.Ct. 1468, 64 L.Ed.2d 15 (1980); Egbert v. Boule, 596 U.S. 482, 490–91, 142
S.Ct. 1793, 213 L.Ed.2d 54 (2022)].

Since then, the Supreme Court has “consistently refused to extend Bivens liability
to any new context or new category of defendants,” Corr. Servs. Corp. v. Malesko,
534 U.S. 61, 68, 122 S.Ct. 515, 151 L.Ed.2d 456 (2001), and “has not implied
additional causes of action under the Constitution,” Egbert, 596 U.S. at 491, 142
S.Ct. 1793. Instead, in recognition that separation of powers principles are central
to the analysis, the Court has “made clear that expanding the Bivens remedy is now
a ‘disfavored’ judicial activity.” [Ziglar v. Abbasi, 582 U.S. 120, 135, 137 S.Ct.
1843, 198 L.Ed.2d 290 (2017)] (quoting Iqbal, 556 U.S. at 675, 129 S.Ct. 1937).
At bottom, the “question is ‘who should decide’ whether to provide for a damages
remedy, Congress or the courts?” Id. (quoting Bush v. Lucas, 462 U.S. 367, 380,
103 S.Ct. 2404, 76 L.Ed.2d 648 (1983)). “The answer most often will be
Congress,” id., as the “Judiciary’s authority to do so at all is, at best, uncertain,”
Egbert, 596 U.S. at 491, 142 S.Ct. 1793. The Constitution entrusts the legislature—
not the courts—with the power to fashion new causes of action. And “it is a
significant step under separation-of-powers principles for a court to determine that
it has the authority, under the judicial power, to create and enforce a cause of action
for damages against federal officials in order to remedy a constitutional violation.”
Abbasi, 582 U.S. at 133, 137 S.Ct. 1843. Therefore, when considering whether to
recognize a new implied cause of action for damages under a constitutional
provision, “our watchword is caution.” [Hernandez v. Mesa, 589 U.S. 93, 101, 140
S.Ct. 735, 206 L.Ed.2d 29 (2020)].

Reflecting these concerns, the Supreme Court has set forth a two-step inquiry to
determine the availability of Bivens remedies in a particular case. See Abbasi, 582
U.S. at 139–40, 137 S.Ct. 1843. First, we ask whether the “case presents a new
Bivens context”—i.e., whether the “case is different in a meaningful way from
previous Bivens cases decided by” the Supreme Court. Id. at 139, 137 S.Ct. 1843.
Only three cases serve as a benchmark: Bivens, Davis, and Carlson. “And our
understanding of a ‘new context’ is broad.” Hernandez, 589 U.S. at 102, 140 S.Ct.
735.

While the Court has not outlined “an exhaustive list of differences that are
meaningful enough to make a given context a new one,” factors to be considered
include:

the rank of the officers involved; the constitutional right at issue; the
generality or specificity of the official action; the extent of judicial
guidance as to how an officer should respond to the problem or
emergency to be confronted; the statutory or other legal mandate
under which the officer was operating; the risk of disruptive
intrusion by the Judiciary into the functioning of other branches; or
the presence of potential special factors that previous Bivens cases
did not consider.

Abbasi, 582 U.S. at 139–40, 137 S.Ct. 1843. “If a case does not present a new
Bivens context, the inquiry ends there, and a Bivens remedy is available.” Shorter,
12 F.4th at 372.

Alternatively, if the case presents a new context, we proceed to the second step of
the inquiry and ask whether there are “special factors counselling hesitation” in
extending Bivens. See Abbasi, 582 U.S. at 136, 137 S.Ct. 1843. The focus at this
second step is “on whether the Judiciary is well suited, absent congressional action
or instruction, to consider and weigh the costs and benefits of allowing a damages
action to proceed.” Id. At this stage, two factors are “particularly weighty: the
existence of an alternative remedial structure and separation-of-powers principles.”
Bistrian v. Levi, 912 F.3d 79, 90 (3d Cir. 2018) (citing Abbasi, 582 U.S. at 136,
137 S.Ct. 1843). But any reason to pause is sufficient to forestall a Bivens
extension. Hernandez, 589 U.S. at 102, 140 S.Ct. 735.

Kalu v. Spaulding, 113 F.4th 311, 325–26 (3d Cir. 2024).
With this recent guidance by the Third Circuit, the Court turns to the issue of whether
Gayle’s Bivens claim presents a new context, and, if so, whether any special factors counsel
against extending a Bivens remedy to this case.
1. New Context
Gayle asserts a Bivens claim against Defendants for violations of his Eighth Amendment
rights in connection with the allegedly inadequate medical care he received for seizures he
occasionally experienced while at USP Canaan. (Doc. No. 11 at 4–9.) In deciding whether

Gayle’s Bivens claim presents a new context, the Court must consider whether this case is
“different in a meaningful way from previous Bivens cases decided” by the Supreme Court. See
Abbasi, 582 U.S. at 139.
Initially, the Court points out that Gayle’s Bivens claim is dissimilar to Bivens itself,
which was a Fourth Amendment “claim against FBI agents for handcuffing a man in his own
home without a warrant,” and Davis, which was a Fifth Amendment “claim against a
Congressman for firing his female secretary . . . .” See id. at 140 (citations omitted). However,
Gayle’s Bivens claim bears some resemblance to Carlson.
In Carlson, the factual allegations of the plaintiff’s Eighth Amendment Bivens claim
were as follows:

At the time of his death on August 15, 1975, Joseph Jones, Jr. was a prisoner in the
federal penitentiary at Terre Haute, Indiana, serving a ten-year sentence for bank
robbery. He had been diagnosed as a chronic asthmatic in 1972 when he entered
the federal prison system. In July 1975, the prisoner’s asthmatic condition required
hospitalization for eight days at St. Anthony’s Hospital in Terre Haute. Despite the
recommendation of the treating physician at St. Anthony’s that he be transferred to
a penitentiary in a more favorable climate, Jones was returned to the Terre Haute
prison. There he was not given proper medication and did not receive the steroid
treatments ordered by the physician at St. Anthony’s.

On August 15 Jones was admitted to the prison hospital with an asthmatic attack.
Although he was in serious condition for some eight hours, no doctor saw him
because none was on duty and none was called in. It was further alleged that
defendant Dr. Benjamin De Garcia, the chief medical officer directly responsible
for the prison medical services, did not provide any emergency procedure for those
times when a physician was not present. As time went on Jones became more
agitated and his breathing became more difficult. Although Jones’ condition was
serious, defendant Medical Training Assistant William Walters, a nonlicensed
nurse then in charge of the hospital, deserted Jones for a time to dispense
medication elsewhere in the hospital. On his return to Jones, Walters brought a
respirator and attempted to use it despite the fact that Walters had been notified two
weeks earlier that the respirator was broken. After Jones pulled away from the
respirator and told Walters that the machine was making his breathing worse,
Walters administered two injections of Thorazine, a drug contraindicated for one
suffering an asthmatic attack. A half-hour after the second injection Jones suffered
a respiratory arrest. Walters and Staff Officer Emmett Barry brought emergency
equipment to administer an electric jolt to Jones, but neither man knew how to
operate the machine. Jones was then removed to St. Francis Hospital in Terre
Haute; upon arrival he was pronounced dead.

Green v. Carlson, 581 F.2d 669, 670 (7th Cir. 1978), aff’d sub nom., Carlson, 446 U.S. at 24.
Like the plaintiff in Carlson,8 Gayle is a federal prisoner seeking a remedy for the alleged
violation of his Eighth Amendment right to adequate medical care. Although the Court does not
discount any discomfort, pain, or emotional distress Gayle may have suffered during his time at
USP Canaan, there are material differences between the facts of this case and those in Carlson.
First, and most significantly, “the injuries at issue are distinguishable from Carlson in both nature
and severity.” See Holton v. Finley, No. 21-cv-00737, 2024 WL 1919238, at *9 (M.D. Pa. Mar.
21, 2024) (“Holton II”), report and recommendation adopted, 2024 WL 1913172 (M.D. Pa. May
1, 2024); see also Bettis v. Grijalva, No. 21-cv-07505, 2023 WL 4141869, at *6 (S.D.N.Y. June
23, 2023) (“Courts have routinely found [that] variances in circumstances and severity render
deliberate indifference claims different from Carlson and thus arise in a ‘new context.’” (citing
cases)). Carlson involved an inmate with a pre-existing and chronic respiratory illness, and “it
was apparent to medical staff that the inmate was suffering from severe and life-threatening
symptoms during an asthma attack.” See Holton II at *9. These severe and life-threatening
symptoms ultimately resulted in the inmate’s death. See Carlson, 446 U.S. at 16 n.1. In this

8 As discussed infra, the plaintiff was decedent’s mother, who was administratrix of his estate.
See id.
case, Gayle alleges that Defendants did not appropriately treat him for occasional seizures he
experienced, with the extent of his injuries being minor injuries to his tongue or lip. Gayle’s
alleged medical issues were thankfully not fatal, and he does not allege that they were remotely
close to life-threatening. See (Doc. Nos. 11 at 4–10; 12 at 1–50); see also Washington v. Fed.

Bureau of Prisons, No. 16–cv–03913, 2022 WL 3701577, at *5 (D.S.C. Aug. 26, 2022)
(“Plaintiff’s Bivens claims do not involve a medical emergency, as did Carlson, but rather focus
on a long term and ongoing course of medical treatment of [p]laintiff’s chronic, non-fatal
condition.”).
Second, Gayle’s allegations in his amended complaint show that he received medical
attention well beyond what the decedent received in Carlson. In Carlson, the inmate never
received competent medical care. Gayle, on the other hand, told Carey on August 28, 2019, that
he had a history of blackouts following a motor vehicle accident in 2015 and yet apparently
never had a prior workup performed. (Doc. No. 12 at 1, 2.) When Gayle complained about
having seizures, he was prescribed antiseizure medication that he generally refused to take. (Id.

at 4, 6.) In addition, the following day, Gayle had a CT scan without contrast performed that was
unremarkable. (Id. at 5.) He later had EEGs performed which did not show any seizure activity.
See, e.g., (id. at 12). Overall, while Gayle complains of allegedly not receiving a diagnosis for
his seizures, he received care throughout the periods described in the complaint, which describe
only occasional seizure episodes. Furthermore, although Gayle alleges that the care he received
was ineffective, he received far more care than the inmate in Carlson.
Third, and finally, the action in Carlson was initiated by the deceased inmate’s estate,
whereas Gayle commenced the instant action pro se. See 446 U.S. at 16 n.1. As such, the
BOP’s administrative remedy program available to Gayle at USP Canaan was unavailable to the
inmate’s estate in Carlson. See Holton II at *9 (finding distinction between Carlson and the case
at issue because “the administrative remedy program available to Plaintiff in the prison was not
available to the inmate’s estate in Carlson”); Washington, 2022 WL 3701577, at *5 (explaining
that the difference between the status of the plaintiff in Carlson and the plaintiff in the case

before the court was “significant for multiple reasons, including that administrative and
injunctive relief would have a completely different application to [p]laintiff’s claims than to the
claims in Carlson”).
Therefore, while the “right at issue” (i.e., the Eighth Amendment) and the alleged
“mechanism of injury” (i.e., the failure to provide adequate medical care) are the same in this
case as in Carlson, the Court concludes that Gayle’s case would extend Carlson to a new context.
See Abbasi, 582 U.S. at 139 (explaining that even claims which challenge the failure to provide
medical treatment can involve the same “right at issue” and “mechanism of injury” as Carlson,
but still have “different” contexts (citing Malesko, 534 U.S. at 64, 70, and n.4)); see also id. at
147 (instructing that “even a modest extension is still an extension” of Bivens). Because Gayle’s

claim presents a new Bivens context, the Court now proceeds to the second step of the analysis
for recognition of a Bivens remedy.
2. Special Factors
In addition to the factual differences between Carlson and the instant case, the Supreme
Court has “explained that a new context arises when there are ‘potential special factors that
previous Bivens cases did not consider.’” See Egbert, 596 U.S. at 492 (quoting Abbasi, 582 U.S.
at 140). As discussed below, the Court concludes that there are special factors here which
counsel against extending a Bivens remedy to Gayle’s Eighth Amendment claims. These special
factors were not considered by the Carlson court, which further supports the Court concluding
that Gayle’s case presents a new context. See Abbasi, 582 U.S. at 148 (instructing that “a case
can present a new context for Bivens purposes . . . if there are potential special factors that were
not considered in previous Bivens cases” (citation omitted)); see also Egbert, 596 U.S. at 492
(acknowledging overlap between the two (2)-part inquiry insofar that the two (2) parts “often

resolve to a single question[,]” i.e., “whether there is any reason to think that Congress might be
better equipped to create a damages remedy”).
As explained by the Supreme Court, a special factor suggests that Congress is better
equipped than the judiciary to “weigh the costs and benefits” of creating a new damages remedy.
See Egbert, 596 U.S. at 492 (citation and internal quotation marks omitted). If “there is any
rational reason (even one) to think that Congress is better suited to ‘weigh the costs and benefits
of allowing a damages action to proceed[,]’” then the Court cannot imply a cause of action for
damages under Bivens. See id. at 496 (citation and internal quotation marks omitted).
Here, there are special factors weighing against extending a Bivens remedy to Gayle’s
claims for alleged violations of his Eighth Amendment rights. First, as briefly mentioned above,

an alternative remedial mechanism existed for Gayle, which “independently foreclose[s] a
Bivens action here.” See Egbert, 596 U.S. at 497. More specifically, the BOP’s Administrative
Remedy Program, which allows federal inmates to seek review of an issue related to “any
aspect” of their confinement, provided an alternative process for addressing Gayle’s claims. See
28 C.F.R. § 542.10(a) (providing that “[t]he purpose of the Administrative Remedy Program is to
allow an inmate to seek formal review of an issue relating to any aspect of his/her own
confinement”); see also Malesko, 534 U.S. at 68 (holding that “administrative review
mechanisms” can provide “meaningful redress and thereby foreclose[] the need to fashion a new,
judicially crafted cause of action[,]” even if those mechanisms do not “fully remedy the
constitutional violation”); Egbert, 596 U.S. at 497 (explaining that “court[s] may not fashion a
Bivens remedy if Congress already has provided, or has authorized the Executive to provide, an
alternative remedial structure” and that, “[i]f there are alternative remedial structures in place,
that alone, like any special factor, is reason enough to limit the power of the Judiciary to infer a

new Bivens cause of action” (citation and internal citations and quotation marks omitted)).
Accordingly, “when alternative methods of relief are available,” as they were here, “a Bivens
remedy usually is not.” See Abbasi, 582 U.S. at 145.
Second, “the Judiciary is not undoubtedly better positioned than Congress to authorize a
damages action” in the context of medical care in federal prisons. See Egbert, 596 U.S. at 492.
The Supreme Court has generally acknowledged that “courts are ill equipped to deal with the
increasingly urgent problems of prison administration and reform[,]” that “[r]unning a prison is
an inordinately difficult undertaking that requires expertise, planning, and the commitment of
resources, all of which are peculiarly within the province of the legislative and executive
branches of government[,]” and that this “task that has been committed to the responsibility of

those branches, and separation of powers concerns counsel a policy of judicial restraint.” See
Turner v. Safley, 482 U.S. 78, 84–85 (1987) (emphasis added) (internal citation and internal
quotation marks omitted). Thus, extending a Bivens remedy to this new context “would step
well into the lawmaking privilege delegated only to Congress, and well over the bounds of [the
Court’s] limited constitutional power.” See Mammana v. Barben, 856 F. App’x 411, 415 (3d
Cir. 2021) (unpublished) (setting forth this principle in the context of a Bivens claim based upon
allegedly unconstitutional conditions of confinement in violation of the Eighth Amendment).
Based on the above, the Court concludes that special factors counsel hesitation in
extending a Bivens remedy to Gayle’s Eighth Amendment claims against the individual
Defendants for deliberate indifference to his serious medical needs. See Egbert, 596 U.S. at 496
(stating that, if “there is any rational reason (even one) to think that Congress is better suited to
‘weigh the costs and benefits of allowing a damages action to proceed[,]’” then the court cannot
imply a cause of action for damages under Bivens (emphasis in original) (citation and internal

quotation marks omitted)). Additionally, while the instant case and Carlson both involve Eighth
Amendment claims of inadequate medical care in the federal prison context, “these superficial
similarities are not enough to support the judicial creation of a cause of action.” See id. at 495
(explaining that “almost parallel circumstances” or “superficial similarities” with Bivens, Davis,
and Carlson “are not enough to support the judicial creation of a cause of action” (citation and
internal quotation marks omitted)).
C. Fourteenth Amendment Bivens Claim
Defendants move for dismissal of Gayle’s Fourteenth Amendment Bivens claim against
the individual Defendants under Rule 12(b)(6) because they are federal officials, and the
Fourteenth Amendment does not apply to them. (Doc. No. 24 at 41–42.) The Court agrees.

The Fourteenth Amendment provides, in relevant part, that “[n]o State shall . . . deprive
any person of life, liberty, or property, without due process of law; nor deny to any person within
its jurisdiction the equal protection of the laws.” U.S. Const. amend XIV, § 1 (emphasis added).
As illustrated by its reference to the “State,” “the Fourteenth Amendment only applies to the
actions of states and not to the federal government . . . .” See Brown v. Philip Morris Inc., 250
F.3d 789, 800 (3d Cir. 2001). Therefore, the Court will grant Defendants’ motion to dismiss
Gayle’s Fourteenth Amendment Bivens claim for the failure to state a claim under Rule 12(b)(6).
To the extent that Gayle meant to assert due process claims under the Fifth Amendment,
which is applicable to federal officials, see Santos v. Sec’y of D.H.S., 532 F. App’x 29, 33 (3d
Cir. 2013) (unpublished) (“[T]he Fifth Amendment applies to actions of the federal government,
not state actions[.]” (citing Citizens for Health v. Leavitt, 428 F.3d 167, 178 n.11 (3d Cir.
2005))), his claims would still fail. In this regard, a prisoner-plaintiff cannot
sustain a Fifth Amendment due process claim under Bivens in light of Ziglar and
its progeny. It is now generally conceded that such inmate due process claims also
present new factual contexts under Ziglar. Railey v. Ebbert, 407 F. Supp. 3d 510,
522 (M.D. Pa. 2019) (collecting cases). Moreover, we have found that the
challenge of prison administration constitutes “a special factor precluding the
extension of Bivens to [an inmate’s] Fifth Amendment due process claim.” Louis-
El v. Ebbert, 448 F. Supp. 3d 428, 440 (M.D. Pa. 2020).

See Cordova v. Garland, No. 22-cv-00816, 2025 WL 19822, at *11 (M.D. Pa. Jan. 2, 2025).
Accordingly, Gayle’s possible Fifth Amendment due process claims against the individual
Defendants will also be dismissed for failure to state a claim due to the lack of a Bivens remedy.
D. Leave to Amend
Having determined that Gayle’s claims against Defendants are subject to dismissal, the
Court must determine whether to grant him leave to replead those claims in a second amended
complaint. Courts should generally give leave to amend but may dismiss a complaint with
prejudice where leave to amend would be inequitable or futile. See Fletcher-Harlee Corp. v.
Pote Concrete Contractors, Inc., 482 F.3d 247, 252 (3d Cir. 2007) (“[I]n civil rights cases district
courts must offer amendment—irrespective of whether it is requested—when dismissing a case
for failure to state a claim unless doing so would be inequitable or futile.”); see also Grayson,
293 F.3d at 108 (“When a plaintiff does not seek leave to amend a deficient complaint after a
defendant moves to dismiss it, the court must inform the plaintiff that [they have] leave to amend
within a set period of time, unless amendment would be inequitable or futile.”). “In determining
whether [amendment] would be futile, the district court applies the same standard of legal
sufficiency as [it] applies under Fed. R. Civ. P. 12(b)(6).” In re Burlington Coat Factory Sec.
Litig., 114 F.3d 1410, 1434 (3d Cir. 1997).
Based on the Court’s analysis of Gayle’s claims, he will not be given leave to file a
second amended complaint because any further amendment would be futile. In this regard, there

are no Bivens remedies available for his claims under the Eighth and Fourteenth Amendments,
or for any possible due process claims under the Fifth Amendment. Additionally, the Court
lacks subject-matter jurisdiction over Gayle’s Bivens claim against the Government, and he has
abandoned any FTCA claim in his amended complaint. Moreover, even if Gayle had not
abandoned his FTCA claim in his amended complaint, he has not included any allegations in his
original complaint or his amended complaint that would demonstrate that he exhausted his
administrative remedies prior to asserting an FTCA claim in this case.
IV. CONCLUSION
For the reasons stated above, the Court will grant Defendants’ motion to the extent they
seek dismissal of Gayle’s claims against the Government under Rule 12(b)(1) for lack of subject-

matter jurisdiction, his Bivens claims against the individual Defendants for deliberate
indifference to his serious medical needs in violation of the Eighth Amendment under Rule
12(b)(6), and his Bivens claims against the individual Defendants for due process violations
under either the Fourteenth or Fifth Amendments under Rule 12(b)(6). The Court will deny
Defendants’ alternative motion for summary judgment as moot. The Court will not grant Gayle
leave to file a second amended complaint and will direct the Clerk of Court to close this case.
An appropriate Order follows.
s/ Yvette Kane
Yvette Kane, District Judge
United States District Court
Middle District of Pennsylvania

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10830479. Public record. Not legal advice.