# Bailey v. United States

> District Court, D. Maryland · August 11, 2025

URL: https://www.frixlaw.com/law-library/cases/11118310

## Case

- **Court:** District Court, D. Maryland
- **Decided:** August 11, 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/11118310

## How later opinions describe it (automated extraction)

- finding that the Act “does not require that the expert and the defendant be the same kind of health care provider”

## Opinion text

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND

DERIS DAVIS BAILEY, et al., *
*
Plaintiffs, *
*
v. * Civil Case No. SAG-23-1175
*
UNITED STATES OF AMERICA, et al., *
*
Defendants. *
*
* * * * * * * * * * * * * *

MEMORANDUM OPINION
Plaintiffs Deris Davis Bailey, individually and as personal representative of the Estate of
Andrew Davis, Keith Davis, Andrea Lynn Davis Fuery, and Alicia Davis (collectively “Plaintiffs”)
filed this wrongful death and survival action against Defendants the United States of America,
Walter Belleza, M.D., and University of Maryland Emergency Medical Associates, P.A.
(“UMEMA”) (collectively “Defendants”) alleging that Defendants’ medical negligence caused
serious injury resulting in the death of Andrew Davis. ECF 1. Defendants Dr. Belleza and
UMEMA have filed a motion in limine to preclude the testimony of Plaintiffs’ expert witness Dr.
Gary Salzman as to emergency physician standard of care, ECF 40. Also pending is a motion in
limine to preclude Dr. Salzman’s testimony concerning care rendered by Nurse Monica Gale
(“Nurse Gale”), ECF 42, and a motion for summary judgment filed by Defendant United States,
ECF 43. The Court has reviewed each of these motions, along with the related oppositions. ECF
44, 45, 46. No replies were filed and no hearing is necessary. See Loc. R. 105.6 (D. Md. 2025).
For the reasons that follow, the motion in limine and motion for summary judgment filed by
Defendant United States will be GRANTED. The motion in limine filed by Defendants Dr. Belleza
and UMEMA will be DENIED.
I. FACTUAL BACKGROUND
This matter arises from alleged medical negligence in the care and treatment rendered to
Plaintiffs’ decedent, Mr. Davis, on January 14, 2020 at the Baltimore Veterans Affairs Medical
Center (“BVAMC”). ECF 1. On the night of January 13, 2020, Mr. Davis was transported from

his long-term care facility to the BVAMC Emergency Room for evaluation and treatment of
fatigue, weakness, abdominal pain, and an episode of dark brown emesis. Id. ¶ 19. In the BVAMC
Emergency Room, Mr. Davis was seen by Dr. Belleza, an emergency medicine physician and
employee of UMEMA who works at BVAMC. ECF 42-7 at 6. A CT scan of the abdomen revealed
that Mr. Davis had incomplete small bowel obstruction. Id. ¶ 20. Placement of a nasogastric
(“NG”) tube into the stomach was recommended to treat the obstruction and prevent aspiration.
Id. ¶ 21. Dr. Belleza and others on the medical team attempted to place an NG tube for Mr. Davis
several times but were unsuccessful. See id.; ECF 42-7 at 38-39.
Subsequently, Nurse Gale, an employee of BVAMC, was able to place the NG tube without
incident. ECF 1 ¶ 22. Dr. Belleza performed a preliminary assessment of the NG tube placement

via auscultation with a stethoscope and air instillation and concluded that the tube was properly
placed. Id. ¶ 23; ECF 42-7 at 51-53. Additionally, Dr. Belleza was able to withdraw fluid from Mr.
Davis’s stomach. ECF 42-7 at 54-55. A portable chest x-ray was ordered and performed, but it
was inconclusive regarding placement of the NG tube. Id. at 73-74; ECF 1 ¶ 25. Mr. Davis’s
oxygen saturation deteriorated, he was placed on high-flow oxygen, and a second chest x-ray and
CT scan were ordered. ECF 42-7 at 74-75; ECF 1 ¶ 25. The CT scan confirmed that the NG tube
was misplaced in Mr. Davis’s left lung. ECF 1 ¶ 26. Mr. Davis passed away the day after his arrival
at BVAMC from respiratory complications related to a pneumothorax (collapsed lung). Id. ¶ 28.
Plaintiffs filed this lawsuit on May 3, 2023, alleging that “Mr. Davis sustained serious
injury leading to this death, extreme physical pain and suffering, and pecuniary loss” as a direct
result of the Defendants’ negligence. ECF 1. Pending now are Defendants’ motions to exclude the
testimony of Plaintiffs’ proffered expert concerning the care rendered by Nurse Gale and Dr.

Belleza, ECF 40, 42 and a motion for summary judgment by the United States, ECF 43. This Court
will first resolve the Daubert motions before turning to the motion for summary judgment.
II. DAUBERT MOTIONS
A. Legal Standard
“The admissibility of expert testimony in a federal court sitting in diversity jurisdiction is
controlled by federal law.” Scott v. Sears, Roebuck & Co., 789 F.2d 1052, 1054 (4th Cir. 1986).
Under the Federal Rules of Evidence, a witness may be qualified as an expert “by knowledge,
skill, experience, training, or education.” Fed. R. Evid. 702. To be admissible, Rule 702 requires
the proffered expert testimony to be (1) helpful to the jury in understanding the evidence or
determining a fact at issue; (2) “based on sufficient facts or data;” (3) “the product of reliable

principles and methods;” and (4) the product of a reliable application of those principles and
methods to the facts of the case.” Id.
Additionally, Rule 702 implicitly “imposes a special gatekeeping obligation on the trial
judge” to ensure that an expert opinion is both relevant and reliable. Nease v. Ford Motor Co., 848
F.3d 219, 229 (4th Cir. 2017); see also Daubert v. Merrell Dow Pharm., 509 U.S. 579, 597 (1993).
In Kumho Tire Co. v. Carmichael, the Supreme Court explictly extended this responsibility to
expert opinions outside of the scientific realm. See 526 U.S. 137, 141-42 (1999). As to the first
aspect of this gatekeeping role, generally, expert testimony is relevant if the expert’s opinion
relates to some issue in the case. See Daubert, 509 U.S. at 591. It requires some valid connection
between the expert’s opinion and the pertinent inquiry at hand. See id. at 592.
The Court’s inquiry into the reliability of an expert’s testimony is “flexible,” and focuses
on “the principles and methodology employed by the expert.” Id. at 594-95; see also Kumho Tire

Co., 526 U.S. at 141 (noting that Daubert’s enumerated factors for reliability is “neither
necessarily nor exclusively applies to all experts or in every case”). In determining whether
proferred testimony is sufficiently reliable, “the court has broad latitude to consider whatever
factors bearing on validity the court finds to be useful; the particular factors will depend on the
unique circumstances of the expert testimony involved.” Westberry v. Gislaved Gummi AB, 178
F.3d 257, 261 (4th Cir. 1999); see also Nease, 848 F.3d at 230. Neither Daubert nor the Federal
Rules of Evidence obligate a trial court “to admit opinion evidence that is [based merely on] the
ipse dixit of the expert.” Gen. Elec. Co. v. Joiner, 522 U.S. 136, 146, 118 S. Ct. 512, 139 L. Ed.
2d 508 (1997). Rather, “[r]eliability is to be determined by the ‘principles and methodology’
employed by the expert.” Holesapple v. Barrett, 5 F. App’x 177, 179 (4th Cir. 2001). Indeed,

“[t]he Court must exclude expert testimony if it is so fundamentally unreliable that it can offer no
assistance to the jury.” Goyal v. Thermage, Inc., Civil No. WDQ-08-0020, 2011 WL 691185, at
*3 n.8 (D. Md. Feb. 18, 2011) (quoting Meterlogic, Inc. v. KLT, Inc., 368 F.3d 1017, 1019 (8th
Cir. 2004)).
B. Motion to Preclude Dr. Salzman from Offering Testimony as to Care Rendered
by Nurse Gale
Plaintiffs bring this action against the United States under the Federal Tort Claims Act
(“FTCA”), due, in part, to the alleged negligent acts of Nurse Gale. ECF 1 ¶¶ 8-9; see United States
v. Orleans, 425 U.S. 807, 813 (1976) (The FTCA “is a limited waiver of sovereign immunity,
making the Federal Government liable to the same extent as a private party for certain torts of
federal employees acting within the scope of their employment.”). Plaintiffs allege that Nurse Gale
and other health care providers breached the standard of care and caused Mr. Davis’s death by
failing to properly treat Mr. Davis; failing to properly place Mr. Davis’ NG tube;
failing to timely and properly recognize that the NG tube was misplaced; failing to
properly supervise nursing care rendered to Mr. Davis; failing to properly supervise
placement of the NG tube; negligently causing Mr. Davis’ pneumothorax; failing
to properly and timely diagnose Mr. Davis’ pneumothorax; failing to timely
intervene and treat Mr. Davis’ pneumothorax; by failing to render appropriate care
within the standard of care to Mr. Davis; and by otherwise failing to take steps to
avoid injury to Mr. Davis.
ECF 1 ¶ 34.
Plaintiffs retained Sarah Jordan, BSN, RN, WCC, CDP, CGCP (“Ms. Jordan”), presumably
as their RN expert. See ECF 42-2 at 3-4. However, during Ms. Jordan’s deposition testimony, she
stated that she was not offering any opinion as to the standard of care or causation with respect to
any of the providers in this case, including Nurse Gale. ECF 42-3 at 5 (“Q: So your role in this
case…was to provide a medical chronology? A: …exactly. Just explaining what I read and what I
identified in the records…Q: But you’re not providing any opinion whatsoever about anything you
read in the records? A: I’m providing no opinion, no causation, no standard of care.”). Plaintiffs
therefore rely solely on the testimony of their other proffered expert, Dr. Salzman, in support of
their claims against all Defendants. See ECF 42-2.
Defendant United States moves to exclude the testimony of Dr. Salzman as to the actions
of Nurse Gale.1 ECF 42. Specifically, the United States contends that, as a critical care physician,
Dr. Salzman is not qualifed “by the necessary experience or training to offer expert opinions in
this case as to the standard of care, breach, or medical causation of a licensed registered nurse.”
ECF 42-1 at 2. Defendant also argues that Dr. Salzman’s expert report and deposition testimony

1 While both Nurse Gale and Dr. Belleza worked at BVAMC, the United States only employed
Nurse Gale. Dr. Belleza worked as an employee of UMEMA.
are insufficient under Federal Rule of Evidence 702 and Federal Rule of Civil Procedure
26(a)(2)(B). This Court grants the motion on both grounds.
i. Maryland Substantive Medical Malpractice Law
Maryland’s Healthcare Malpractice Claims Act (the “Act”) establishes the qualifications

required of a health care provider proffered to testify concerning a defendant’s compliance with,
or departure from, the applicable standard of care. See Md. Code (1974, 2020 Repl. Vol.), §3-2A-
02(c)(2)(ii)(1)(B), Courts & Judicial Proceedings Article (“CJP”).2 The Act requires a plaintiff
seeking to recover for injuries caused by medical malpractice to provide by a preponderance of the
evidence “(1) the applicable standard of care; (2) that this standard has been breached; and (3) a
causal relationship between the violation and the injury.” Harris-Reese v. United States, 615 F.
Supp. 3d 336, 367 (D. Md. 2022) (citation omitted). Experts are usually necessary to establish the
standard of care for professionals who have special training and expertise, like doctors and nurses,
as well as the breach of that standard and causation. Green v. Obsu, No. ELH-19-2068, 2022 WL
2971950, at *20 (D. Md. July 27, 2022).

As to the standard of care, a professional with specialized training must “use that degree of
care and skill which is expected of reasonably competent practitioner in the same class to which
[the professional] belongs, acting in the same or similar circumstances.” Id. (citation omitted).
Additionally, the Act requires that a qualified expert testifying as to the defendant’s compliance
with or departure from the applicable standard of care must “have had clinical experience, provided
consultation relating to clinical practice, or taught medicine in the defendant’s specialty or a related

2 Under the FTCA, “liability of the United States is determined by the law of the place where the
act or omission occurred.’” Kerstetter v. United States, 57 F.3d 362, 366 (4th Cir. 1995) (citations
omitted). Since Plaintiffs’ claims are based on events that took place in Maryland, the substantive
law of Maryland applies. Id.
field of health care, or in the field of health care in which the defendant provided care or treatment
to the plaintiff, within 5 years of the date of the alleged act or omission giving rise to the cause of
action,” and must be “board certified in the same or related specialty as the defendant” if the
defendant is board certified in a specialty. CJP, §3-2A-02(c)(2)(ii)(1)(A), (B). Under Act,

specialities and fields of health care are “related” if “there is an overlap in treatment or procedures
within the specialities and therefore an overlap of knowledge... among those experienced in the
fields or practicing in the specialties, and the treatment or procedure in which the overlap exists is
at issue in the case.” Hinebaugh v. Garrett Ctny. Mem. Hosp., 51 A.3d 673, 683 (Md. Ct. Spec.
App. 2012).
Defendant United States argues that Dr. Salzman is not qualifed to testify as an expert
regarding the standard of care, breach of that standard, or medical causation as applied to Nurse
Gale’s conduct in this matter because their specialties are not “related” under the Act. ECF 42-1.
This Court agrees.
Dr. Salzman is a medical doctor who completed his Internal Medicine residency in 1983

and Pulmonary Critical Care Fellowship in 1985. ECF 40-5 at 1-2. He is board certified in Internal
Medicine, Pulmonary Disease, and Critical Care Medicine. Id. at 2; ECF 42-8 at 5. Unlike Nurse
Gale, Dr. Salzman is not licensed in nursing and has never served as a licensed RN. ECF 40-5. Dr.
Salzman does not work in the emergency department and does not supervise nurses in the
emergency department setting. ECF 42-8 at 19, 5-7. And Dr. Salzman testified that a nurse’s role
is to follow the orders of the supervising doctor, indicating that each play distinct roles in patient
care. ECF 42-8 at 21; see also Chaplin v. Univ. of Maryland Med. Sys. Corp., 2019 WL 5488457
at *3 (Md. Ct. Spec. App. Oct. 25, 2019) (finding no overlap between transplant coordinator nurse
and transplant surgeon because nurses “act pursuant to instructions given by surgeons”). Thus, as
a critical care physician, Dr. Salzman’s specialty does not “overlap” in treatment, procedures, or
knowledge with that of an emergency department nurse such as Nurse Gale enough to qualify as
a “related field of health care” under the Act. See CJP, §3-2A-02(c)(2)(ii)(1)(A); Hinebaugh, 51
A.3d at 686. Under Maryland law, Dr. Salzman cannot opine as to the standard of care governing

Nurse Gale’s actions in this case.
ii. Federal Procedural Law
Dr. Salzman’s opinions as to the care rendered by Nurse Gale are also insufficient under
Federal Rule of Civil Procedure 26(a)(2)(B) and Federal Rule of Evidence 702. Rule 26(a)(2(B)
sets forth the requirements for experts who must provide a written report, including that the report
contain “a complete statement of all opinions the witness will express and the basis and reasons
for them” along with “the facts or data considered by the witness in forming them.” Id. (a)(2)(B)(i),
(ii). Here Dr. Salzman’s two-page report fails to provide “the basis and reasons” for his opinions
regarding the specific actions of Nurse Gale. Instead, the report generally states that, “Dr. Belleza,
[Nurse Gale], and the Medicine Team…violated the standard of care by repeatedly trying to insert

an NG tube multiple times in a patient with a history of esophagaeal stricture.” ECF 42-5 at 3. The
record reflects that Nurse Gale knew of only one previous attempt to insert the NG tube,
subsequently made only one attempt (which was successful), and was not aware of Mr. Davis’s
history of esphogeal stricture. See ECF 42-6 at 20. Dr. Salzman’s report lacks any description of
how he reached his opinion as it relates specifically to Nurse Gale’s actions or the facts or data he
considered in reaching his opinion. See Cohlmia v. Ardent Health Servs., LLC, 254 F.R.D. 426,
432 (N.D. Okla. 2008) (expert reports were insufficient under Rule 26 because they did not “set
forth the expected testimony of the experts as to how and why they reached their opinions”). Dr.
Salzman’s report thus does not meet the requirements of Rule 26.
Dr. Salzman’s opinions as to Nurse Gale are also inadmissible under Federal Rule of
Evidence 702. He opines that the standard of care required the “health care providers” in this case
to proceed with one of three “acceptable” options after an initial attempt at NG tube placement in
Mr. Davis was unsuccessful: “(1) treat the incomplete small bowel obstruction with NPO and

bowel rest without an NG tube, (2) consult a radiologist to place the tube under fluroscopy imaging,
or (3) consult gastroenterology to place the tube under direct visualization with upper endoscopy.”
ECF 42-5 at 3. None of these treatment decisions would be made by an emergency department
nurse like Nurse Gale. While Dr. Salzman alleges that Nurse Gale has breached the standard of
care, his report and opinions make no reference to the standard of care pertaining specifically to
nurses. Dr. Salzman’s opinions as to Nurse Gale must be excluded because they would not assist
the trier of fact in determining whether Nurse Gale breached the applicable standard of care. See
Honey-Love v. United States, 664 F. App’x 358 360-61 (5th Cir. 2016) (differentiating between
the standard of care applicable to doctors and that applicable to nurses and excluding expert’s
testimony for failing address the requisite standard).

Dr. Salzman is therefore precluded from offering expert testimony in this matter as to the
care rendered by Nurse Gale.
C. Motion to Preclude Dr. Salzman from Offering Testimony as to Emergency
Physician Standard of Care

Plaintiffs allege that Dr. Belleza breached the standard of care in failing to properly treat
Mr. Davis and have also retained Dr. Salzman to provide standard of care and causation opinions
in support of that claim. ECF 1 ¶ 34; ECF 35. Defendants Dr. Belleza and UMEMA allege that as
a pulmonary and critical care specialist, Dr. Salzman is not qualified to render standard of care
testimony as to Dr. Belleza, an emergency room physician, and Dr. Salzman’s testimony must be
excluded under the Act. ECF 40. Specifically, Defendants contend that because Dr. Salzman is not
board certified in the same or related specialty as that of Dr. Belleza, Dr. Salzman should be
precluded from offering any standard of care testimony as to Dr. Belleza’s actions. Id. Defendants
also argue that Dr. Salzman does not routinely place NG tubes, has never attempted placement of
an NG tube in a patient with an esphogeal stricture, and has never been called to the emergency

department to place an NG tube. ECF 40-1 at 14-15. As such, Defendants contend, Dr. Salzman is
“not sufficiently familiar with the standard of care for an emergency physician with regard to the
placement of an NG tube in an emergency room setting (particularly for a patient who may have
an esophogeal stricture) to offer standard of care criticisms against Dr. Belleza.” Id. at 15.
In support of these arguments, Defendants rely on two Maryland appellate court cases
addressing the concept of “related specialty” under the Act. In Street v. Upper Chesapeake Medical
Center, Inc., 311 A.3d 321 (Md. Ct. App. 2024), the appellate court reviewed the trial court’s in
limine ruling precluding plaintiff’s board certified vascular surgery expert from testifying that the
defendant emergency room physician had breached the standard of care by failing to arrange for a
consultation by a vascular surgeon. Id. at 335. Exploring Maryland case law on the meaning of

“related specialty” under the Act, the Street court noted that “whether specialities are related
depends upon the circumstances of the case and in particular upon whether there is treatment
overlap between the specialties.” Id. at 332. The court found that “overlap and symmetry in
treatment” was lacking because the expert vascular surgeon “sees patients already thought to have
vascular disease, not patients presenting for an initial assessment of their symptoms.” Id. at 335.
As such, the court upheld the trial court’s ruling that the vascular surgeon was not board certified
in a specialty “related to” that of the defendant emergency room physician under the Act. Id.
Defendants also rely on Hinebaugh v. Garrett County Memorial Hospital, 51 A.3d 673
(Md. Ct. Spec. App. 2012). In that case, the court of appeals found that the plaintiff’s expert, a
dentist board certified in oral and maxillofacial surgery (“OMS”), was not in a specialty “related”
to any of the defendant doctors, one board certified in family medicine and two board certified in
radiology, and thus could not testify as to their standard of care. After being hit in the face, the
plaintiff was evaluated by the defendant family medicine physician, who ordered x-rays to

determine whether the plaintiff had facial fractures. Id. at 687. The defendant radiologists
performed and read the x-rays, concluding they showed no bone fractures in plaintiff’s face. Id.
The plaintiff’s OMS expert opined that all three defendants breached the standard of care by failing
to perform a CT scan of plaintiff’s face after the simple x-rays did not show any broken bones. Id.
at 687-88. Analyzing the OMS expert’s affidavit, the appellate court found that the OMS expert
focused solely on “explaining the standard of care that govern OMS dentists” who are called in as
consultants and not the standards that apply “to family medicine doctors or radiologists confronted
with a patient who complains of pain as a result of being hit in the face.” Id. at 688. The court
found that the OMS expert did not “opine that the standard of care for either family medicine
doctors or radiologists overlaps that of an OMS specialist.” Id. Noting that the “relatedness” of the

specialties is assessed according to the context of the case, the court concluded that, unlike family
medicine and radiology doctors, “OMS dentists are not front line health care providers” and did
not stand on “equal footing with respect to the diagnosis and treatment of facial fractures in front
line patients.” Id. at 689.
Here, the Court must determine whether, under the Act, the subject matter of Dr. Salzman’s
specialties, internal medicine and pulmonary and criticial care, overlap sufficiently with Dr.
Belleza’s specialty in emergency medicine with respect to the treatment of Mr. Davis, a patient
with a history of esopheageal stricture who required NG tube placement in the emergency room
setting. In analyzing the “relatedness” of these specialties, this Court focuses on whether they share
the ability to address the medical need at issue and finds Nance v. Gordon, 62 A3d 185 (Md. Ct.
Spec. App. 2013), instructive. In Nance, the court concluded that nephrology and urology were
“related specialties” because “the treatment rendered (a differential diagnosis at the time the patient
presents to the emergency room)” was performed by both specialties. Id. at 194. The court relied

on the fact that the expert, a board certified nephrologist, “personally participated in the same kinds
of ‘on-call services for emergency departments’ as the treatment [the plaintiff] received” from the
defendant urologists, to find that the expert was a “front line health care provider” like the
defendants and thus could testify as to the applicable standard of care. Id.
Here, Dr. Salzman testified that he sees, manages, and consults on patients in the
emergency department for issues related to pulmonary and critical care and internal medicine. ECF
42-8 at 5. Thus, like Dr. Belleza and the nephrologist expert in Nance (and unlike the vascular
surgeon in Street and the OMS dentist in Hinebaugh), Dr. Salzman is actively involved in treating
emergency room patients and is a “front line health provider.” See Nance, 62 A.3d at 194;
Hinebaugh, 51 A.3d at 689-90.

Defendants have not argued that the standard of care for placement and management of an
NG tube for a patient in the emergency department differs from that for a patient in the critical
care or intensive care unit. Instead, Defendants incorrectly focus on Dr. Salzman’s lack of training
and certification in emergency medicine, failing to recognize that treatment rendered to Mr. Davis
falls within the overlapping expertise of emergency medicine and pulmonary and critical care,
rendering Dr. Salzman’s expertise pertinent to the treatment and procedure at issue. See
Hinebaugh, 51 A.3d at 21 (finding that the Act “does not require that the expert and the defendant
be the same kind of health care provider”). Dr. Salzman is well versed in pulmonary complications
related to the placement of an NG tube, particularly as they relate to the circumstances in this case
where the tube was incorrectly placed in the patient’s lung, recognition of the incorrect placement
was delayed, and the patient clinically deteriorated and later died as a result. See ECF 42-8 at 10-
12, 20. Dr. Salzman has published a medical article discussing such pulmonary complications
relating to tube placement and has managed the placement of NG tubes for patients at risk of

complications. See ECF 44-2; ECF 42-8 at 4, 19; Nance, 62 A.3d at 195. Plaintiffs have established
an overlap in knowledge and treatment between the specialties of emergency medicine and internal
medicine and pulmonary and critical care as it relates to placement and management of an NG
tube. See Nance, 62 A.3d at 196 (“the procedure at issue in the instant case…is one both healthcare
providers have experience with” (citation omitted)). Based on the record, the Court concludes that
Dr. Salzman can offer testimony regarding the standard of care as it relates to the actions of Dr.
Belleza in this case.
III. MOTION FOR SUMMARY JUDGMENT
Defendant United States moves for summary judgment, contending that Plaintiffs are
unable to establish the elements of their medical malpractice claim. Specifically, the United States

argues that without an expert to opine on the care rendered by Nurse Gale, Plaintiffs cannot
establish a prima facie case of medical negligence against the United States. This Court agrees.
As noted above, Maryland law requires that a medical malpractice plaintiff prove three
elements by a preponderance of the evidence: “(1) the applicable standard of care; (2) that this
standard has been breached; and (3) a causal relationship between the violation and the injury.”
Ford v. United States, 165 F. Supp. 3d 400, 422 (D. Md. 2016). In cases involving professional
negligence, expert testimony is ordinarily required to establish the standard of care, breach of that
standard, and causation because such standards require specialized knowledge within the
professional’s field that are generally “beyond the ken of the average layman.” Green, 2022 WL
2971950, at *20 (citation omitted).
Because Plaintiffs bear the burden of establishing the elements of their medical malpractice
as to Nurse Gale, the exclusion of Dr. Salzman’s expert testimony as to the care rendered by Nurse

Gale is fatal to Plaintiffs’ malpractice claims against the United States. Courts have found that
summary judgment is appropriate where there is an absence of evidence to support the non-moving
party’s case. See id. at *24; Rodriguez v. Clarke, 926 A.2d 736, 755, 348 (Md. Ct. App. 2007) (If
expert testimony regarding negligence and causation is lacking, “the court may rule…that there is
not sufficient evidence to go [to] the jury.” (citation omitted)); Honey-Love, 664 F. App’x at 363
(upholding summary judgment where expert report was excluded); Williams v. Mosaic Fertilizer,
LLC, No. 8:14-cv-1748, 2016 WL 7175657, at *17 (M.D. Fla. June 24, 2016) (granting summary
judgment when plaintiff’s expert was excluded from testifying). Defendant United States is
entitled to summary judgment because Plaintiffs have failed to proffer expert testimony
establishing the standard of care, breach, and causation related to the conduct of Nurse Gale.

IV. CONCLUSION
For the reasons set forth above, the United States’s motion in limine, ECF 42, and motion
for summary judgment, ECF 43 are GRANTED. Judgment is entered in favor of the United States
on all claims. The motion in limine by Defendants Dr. Belleza and UMEMA to preclude Dr.
Salzman from offering testimony concerning the care rendered by Dr. Belleza, ECF 40, is
DENIED. A separate Order follows.

Dated: August 11, 2025 /s/
Stephanie A. Gallagher
United States District Judge

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11118310. Public record. Not legal advice.