# Holton

> District Court, M.D. Pennsylvania · February 3, 2026

URL: https://www.frixlaw.com/law-library/cases/11304819

## Case

- **Full name:** Ruben C. Holton v. United States of America
- **Court:** District Court, M.D. Pennsylvania
- **Decided:** February 3, 2026
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF PENNSYLVANIA
RUBEN C. HOLTON, : No. 4:22-CV-70
Plaintiff (Saporito, J.)
Vv. (Caraballo, M.J.)
UNITED STATES OF
AMERICA, :
Defendant
REPORT AND RECOMMENDATION
I. Introduction
On January 13, 2022, plaintiff Ruben Holton, a former federal
inmate previously housed at Federal Correctional Institution,
Schuylkill “FCI Schuylkill”), proceeding pro se, initiated this action
pursuant to the Federal Tort Claims Act (“FTCA”) against the United
States of America and three of its employees, alleging tort injuries
relating to medical treatment he received at FCI Schuylkill. Doc. 1. On
March 11, 2025, the Court dismissed all but two of Holton’s claims
against the sole remaining defendant, the United States. Doc. 53. Those
two claims allege that the United States was negligent, both
professionally and ordinarily, in its treatment of Holton in February

2021 and thereafter, after he complained of Coronavirus disease 2019
“COVID-19”) symptoms, and eventually tested positive for COVID-19.
Doc. 1 at 2-5.
The Court has federal question jurisdiction, pursuant to 28 U.S.C.
§ 1831. On July 25, 2025, the United States moved for summary
judgment on both claims. Doc. 5. The motion is now fully briefed and
ripe for decision, and was referred to the undersigned to issue the
instant Report and Recommendation, pursuant to 28 U.S.C. § 636. As
set forth below, the undisputed material facts show that Holton cannot
establish certain elements of his claims. Accordingly, the undersigned
recommends granting the United States’ motion for summary judgment
and dismissing the remaining claims with prejudice.
II. Background
A. Relevant Procedural History
Holton was an inmate at FCI Schuylkill from March of 2018 to
September 22, 2022. Doc. 33 at 3; Doc. 59 at 2. The facts underlying this
action occurred “over a twenty-one day period in February and March of
2021. During this period, Plaintiff contracted Covid-19, and allegedly
received inadequate treatment.” Doc. 38 at 5.

Holton filed his operative complaint on January 13, 2022. Doc. 1.
In addition to asserting professional and ordinary negligence claims
against the United States, the complaint originally asserted claims
against Bret Brosious, Ellen Liebson-Mace, and Mary Spiese, all of
whom were medical professionals employed at FCI Schuylkill who
treated Holton during February and March of 2021. Id. at 1—5.
The United States moved to dismiss the complaint on February 6,
2028. Doc. 24. In its motion, the United States contended that Holton
failed to file a certificate of merit as required under Pennsylvania law,
and thus failed to state a medical negligence claim, and that the Court
lacked subject matter jurisdiction. Doc. 25 at 5-12,
In a Report and Recommendation filed on August 31, 2023, the
Honorable William I. Arbuckle recommended that the Court deny the
United States’ motion. Doc. 33. Specifically, Judge Arbuckle concluded
that the Court had subject matter jurisdiction over Holton’s claims, and
that Holton was not required to file a certificate of merit. Jd. at 19-24.
He likewise concluded that, in addition to a medical negligence claim,
Holton also advanced an ordinary negligence claim. Id. at 23-25.
Finally, Judge Arbuckle recommended sua sponte dismissal of

defendants Brosious, Liebson-Mace, and Spiese, because they were not

proper parties under the FTCA. Doc. 33 at 25-26. On September 25,
2023, the Court adopted the Report and Recommendation and
dismissed Brosious, Liebson-Mace, and Spiese from the action, but
denied the United States’ motion in all other respects. Doc. 34 at 2-4.
The United States answered the complaint on October 238, 2023.
Doc. 37. On November 16, 2028, the United States moved for judgment
on the pleadings. Doc. 40. In its motion, the United States contended
that Holton’s allegations were insufficient to plead all four required
elements of a negligence claim: duty, breach, causation, and injury. Doe. □

41 at 5. The United States specifically contended that “Holton has not
alleged facts establishing a causal connection between the BOP’s failure
to administer COVID-19 tests on the one hand, and Holton’s exposure
to and contraction of COVID-19 on the other hand.” Jd.
In a Report and Recommendation filed on October 28, 2024, Judge
Arbuckle recommended that the Court deny the United States’ motion.
Doc. 50. Judge Arbuckle concluded that the United States misconstrued
Holton as asserting an ordinary negligence claim for failure to
administer COVID-19 tests, when Holton actually asserted a medical

malpractice claim for such a failure. Id. at 14-15. Judge Arbuckle
further concluded that the United States only addressed the injuries
Holton allegedly suffered as a result of contracting COVID-19, and not
the additional lingering and permanent injuries Holton allegedly
suffered after contracting COVID-19. Id. at 16-17.
On March 11, 2025, the Court adopted the Report and
Recommendation as modified. Doc. 58. Specifically, the Court dismissed
those portions of Holton’s claims alleging that his contraction of
COVID-19 constituted an actionable injury, but declined to dismiss the
allegations that he suffered injury from the development of prolonged
and lingering COVID-19 symptoms. Doc. 52 at 14—25; Doc. 53 at 1. In
addressing the claimed long-term injuries, the Court concluded that
Holton “has pled sufficient facts to support his ordinary and
professional negligence claims for his prolonged and permanent COVID-
19 symptoms, and thus, we will deny the defendant’s motion for
judgment on the pleadings on this claim.” Doc. 52 at 24. The Court
emphasized that its ruling was premised solely on the allegations in the
pleadings, noting that “[t]his holding, however, does not excuse the
plaintiffs burden in proving the requisite elements of a medical

malpractice claim, including potential testimony from a medical expert
to prevail on that claim. ... Our holding, however, does not impact the
potential viability of the defendant’s contention that the plaintiff needs
to present expert testimony to ultimately prevail on his claim.” Id. at
24, n.9.
That historical litigation left Holton with two remaining claims

now before the Court. First, in his professional negligence claim,
commonly referred to as a medical malpractice claim, Holton alleges
that FCI Schuylkill medical professionals had a duty to follow
“generally accepted medical standards.” Doc. 52 at 22; Doc. 1 at 5. He
alleges that FCI Schuylkill medical professionals breached this duty
when, during two medical visits on February 22 and 23, 2021, they
failed to test him for COVID-19 after he complained of COVID-19
symptoms, and that this increased his risk of developing permanent
and prolonged COVID-19 symptoms, which he subsequently developed.
Id. at 3-5; Doc. 52 at 23.
Second, in his ordinary negligence claim, Holton alleges that FCI
Schuylkill medical professionals had a duty to provide him with
“suitable quarters and provide for” his “safekeeping [and] car[e],”

pursuant to Title 18, United States Code, Section 4042. Doc. 52 at 22;
Doc. 1 at 5. He alleges that FCI Schuylkill medical professionals
breached this duty when, during two medical visits on February 22 and
23, 2021, and during Holton’s quarantine after testing positive for
COVID-19 from March 3 to March 15, 2021, they failed to “properly and
satisfactorily look into [] [his] complaint of Chest Pain/Difficulty
Breathing,” and that this increased his risk of developing permanent
and prolonged COVID-19 symptoms, which he subsequently developed.
Id. at 38-5; Doc. 52 at 28.
On July 25, 2025, the United States moved for summary judgment

on these claims, and concurrently filed a statement of material facts.
Doc. 58. In its motion, the United States contends that summary
judgment should be granted in its favor on the professional negligence
claim, because Holton cannot make a prima facie showing of medical
malpractice without expert testimony. Doc. 60 at 10-12. For both the
professional negligence and ordinary negligence claims, the United
States contends that Holton cannot, on the record, establish breach of

any duty of care, or that any breach caused his lingering symptoms. Id.
at 12-15.

Holton filed a timely opposition, albeit without a counter
statement of material facts, on August 20, 2025. Doc. 61. In his
opposition, Holton counters that he has “successfully pled adequate
facts to show a nexus between his lingering & permanent symptoms of
COVID-19 and the Defendants alleged breaches.” Doc. 61-1 at 3. He
also avers that he can “make a Prima Facie showing of Medical
Malpractice without an expert.” Id.!
B. Factual Background
Concurrent with its motion for summary judgment, and pursuant
to Local Rule 56.1, the United States filed a statement of material facts
with supporting exhibits. Docs. 58, 59. As detailed above, Holton has
not submitted his own counterstatement of material facts. Holton has,
however, attempted to oppose some of the United States’ factual
averments in his brief.

1 Holton has a second, similar FTCA action pending before the Court. See Holton v.
United States, No. 4:22-CV-487 (M.D. Pa. 2022). In that action, Holton asserts
claims for ordinary and professional negligence based upon allegations that
“medical professionals at FCI Schuylkill responded negligently to a variety of
medical issues for which he sought treatment.” Id. (Doc. 62 at 1). The United States
also filed a pending motion for summary judgment in that action, where, as here,
they contend that Holton failed to produce medical expert testimony, and that the
evidence does not establish breach and causation. Jd. (Doc. 51 at 10-31).

In this regard, Holton avers that, contrary to the United States’
statement of facts, he “was Symptomatic during his March 2, 2021
COVID-19 Infection and was not checked on regularly during his time
in isolation. Plaintiff also didn’t have Minimal bibasilar March 2, 2021
COVID-19 infection.” Doc. 61-1 at 2 (errors in original) (internal citation
omitted). Moreover, Holton disputes the United States’ characterization
of some of his medical records, contending that while an expert report
generated by the United States claims that he “did not report hallmark
symptoms such as fatigue, cognitive dysfunction etc.,” his records show
that he did report these symptoms. Jd. at 3. Finally, Holton also
contests the expert report's conclusion that his respiratory “complaints
may be confounded by his chronic asthma & tobacco use,” saying that
he never smoked a day in his life and that one of his clinical records
from his time at FCI Schuylkill shows that, regarding his breathing
problems, medical staff said, “recovery from Covid may take some time.”
Id. at 3-4.
This submission, however, is procedurally defective, because
litigants who oppose a motion for summary judgment must submit their

own statement of facts that responds directly and correspondingly to

the movant’s statement of facts. M.D. Pa. L.R. 56.1. In the absence of
such opposition, “[a]ll material facts set forth in the statement required
to be served by the moving party will be deemed to be admitted ....” Id.
Furthermore, pro se litigants are required to follow the local rules
equally with all other litigants. See Vogt v. Wetzel, 8 F.4th 182, 185 (8d
Cir. 2021) (pro se litigants “cannot flout procedural rules—they must
abide by the same rules that apply to all other litigants.”) (quoting Mala

v. Crown Bay Marina, Inc., 704 F.3d 239, 244—45 (8d Cir. 2018)).
Accordingly, as Holton did not avail himself of the opportunity to
submit a complete counterstatement of facts, those portions of the
United States’ statement of material facts and its accompanying
exhibits that Holton did not directly refute are deemed unopposed and
admitted. See Liberty Bell Bank v. Rogers, 726 F. App’x 147, 150—51 (3d
Cir. 2018) (“Because [the defendant] neglected to file a responsive
statement of material facts, the District Court was entitled to deem the
statement of facts as admitted.”); Krushin v. Wolff, 2023 WL 2472601,
at *2—3 (M.D. Pa. 2023) (deeming the accompanying statement of facts
admitted under Local Rule 56.1, for defendant’s failure to respond).

10

As set forth in the United States’ statement of material facts and
its accompanying exhibits, prior to February of 2021 and since at least
2012, Holton underwent treatment for asthma. He likewise received
treatment for an anxiety disorder since at least 2020. Doc. 59-3 at 31;
59-4 at 35-40, 48-50, 84-86, 138, 140-41, 146-47, 150, 152, 156.
Additionally, the medical records submitted by the United States show
that Holton was treated on numerous occasions during 2020 for various
physical symptoms with a suspected connection to one or both of those
underlying conditions. Jd. at 146 (“Inmate Holton reported again that
he is ‘really not feeling good, and endorsed various physical symptoms
of anxiety, to include digestive problems/stomach upset, headaches, and
muscle pain/tension. ... [After consultation with Holton’s other
physician,] [s]he reported he has been examined on numerous occasions,
and has continued to endorse additional symptoms, without apparent
medical basis for these concerns.”).
On March 17, 2020, while in Bureau of Prisons (“BOP”) custody,
Holton presented to sick call complaining of shortness of breath,
headache, coughing, and diarrhea. BOP medical staff made normal
examination findings, noting that Holton was not “acutely ill and in no

11

acute distress at this time[.]’ Id. at 983-94. Holton returned to sick call

on March 25, 2020, again complaining of shortness of breath and chest
tightening, but reporting that his albuterol inhaler relieved his
symptoms. Jd. at 89. Staff noted no acute distress or illness and
reinforced to Holton the importance of “proper inhaler use.” Jd. at 91.
Holton returned to sick call on June 30, 2020, again complaining
of ear pain spreading to his jaw, neck, and sinuses. Id. at 73. Staff
examined him and noted that his ear drums were “intact, bulging, air
bubbles observed behind membrane” but that there was “[n]o obvious
swelling, drainage, or erythema on section, not warm to touch.” Staff
also confirmed that “hearing appears intact.” Id. at 75. Staff prescribed
antibiotics and ordered an X-ray “to evaluate for mastoid pain.” Staff
otherwise recommended over-the-counter medications. Doc. 59-4 at 75.
Holton returned to sick call on September 16, 2020, where he
reported complaints of nausea and chest pain. He reported that “[h]e
doesn’t want to go to work today because of his symptoms, and he also

states that he hasn’t had a day off yet this week.” Id. at 41. His
examination revealed no abnormal findings. Jd. at 39. Holton returned

to sick call the next day, September 17, 2020. Id. at 35. He complained

12

of chest pain, breathing problems, ear pain, stomach cramps, and other
symptoms. Medical staff reminded Holton “that he ha[d] been seen for

many of these complaints in HSU a number of times over the past
year|.]” Jd. His physician explained to Holton that his anxiety “can often

cause symptoms similar to what he listed” and encouraged him to take
his anxiety medication. Id. at 39.
On September 18, 2020, Holton had a psychiatric session where he
“endorsed various physical symptoms of anxiety, to include digestive
problems/stomach upset, headaches, and muscle pain/tension.” Id. at
146. Psychiatry staff described Holton’s presentation as “dysphoric” and
noted that “inmate Holton appeared to be actively exaggerating
symptoms, to include rubbing his eyes as though his vision was affected,
rubbing his face/holding his head, tapping his ear as if he was having
difficulty with his hearing/popping his ear, and at times rocking lightly
in his chair as he described symptoms.” Doc. 59-4 at 146. Prior notes
taken by psychiatry staff on September 11, 2020, contained similar
findings to those on September 18, stating that Holton “[d]emonstrates
anxiety symptoms, evidence by physical symptoms of panic (e.g. racing
heart, tight chest), worry, feelings for foreboding, and significant sleep

13

disturbances (e.g. nightmares, sleep paralysis, hypnogogic/hypnopompic
hallucinations).” Jd. at 151.
Holton presented again to sick call on October 8, 2020. Id. at 28.
He complained of head and earaches. Jd. Holton’s evaluation revealed
nothing abnormal. Jd. at 30. Medical staff recommended acetaminophen
for pain and Nasacort and Claritin for his sinus discomfort. Id.
Holton made an urgent visit to sick call on November 23, 2020,
complaining of intense chest pain. Jd. at 9-13. Medical staff performed
an EKG on Holton, during which he “appeared in no acute distress... .”
Doc. 59-4 at 11. The EKG revealed no abnormalities. Jd. Holton
presented to sick call again on November 29, 2020, with continued
complaints of chest pain. Id. at 5. Medical staff performed another EKG,
which again revealed normal findings. Jd. at 6. Holton’s vitals were also
normal. Jd. Nonetheless, the BOP sent Holton to an outside emergency
room for further evaluation. Id. At the hospital Holton reported “left
sided chest pain” that “is stabbing and aching in nature.” Id. at 165. An
EKG performed there was “normal.” Doc. 59-4 at 166. Imaging studies
performed at the hospital revealed “no specific evidence of active
disease in the chest.” Jd. at 173.

14

On December 14, 2020, the BOP collected a specimen to test
Holton for COVID-19, the results of which were negative. Id. at 160.
This appears to be the first instance in the medical records in which
Holton was tested for COVID-19.
In February 2021, Holton presented twice to sick call complaining
of chest pain and breathing issues. These two visits form the factual

core of Holton’s claims. First, on February 22, 2021, Holton complained
about “the same chest pain he was having before when he went to the
hospital in November[]” 2020. Doc. 59-5 at 105. Medical staff reviewed
those November hospital records with Holton, noting that the hospital
found his chest pain to be musculoskeletal and that his EKG findings
were normal. Jd. For reasons that are unclear, Holton terminated this
encounter before undergoing an examination or receiving any additional
treatment. Id. The following day, February 23, 2021, Holton returned to
sick call and complained of chest pain and difficulty breathing,
explaining to staff that his “symptoms are the same as they always
are.” Id. at 103. Staff performed a general exam and an EKG, both of
which showed no abnormalities. Jd. at 1038-04, 228. Holton was

15

discharged and told to return as needed and if his condition worsens. Id.
at 104.
On March 3, 2021, the BOP tested Holton for COVID-19 because
he was identified as a close contact with another inmate who had tested
positive. Doc. 59-5 at 90. Despite Holton being asymptomatic, the test
results came back positive. Id. As noted above, Holton refutes that
characterization, claiming that he was symptomatic during the March
3, 2021, visit, but the medical records he offers in support of this
assertion do not corroborate his claim. Doc. 61-2 at 1-5. Holton was
then placed in isolation and prescribed acetaminophen. Id. at 91.
Although Holton avers that he was not checked on regularly while
in isolation, Doc. 61-1 at 2, the evidence offered by the United States
shows that FCI Schuylkill medical staff monitored Holton and took his

temperature several times over the ensuing days. Id. at 116. On March
8, 2021, Holton first reported intermittent shortness of breath and a
non-productive cough. Id. at 87. He denied fever and chest pain and had

no additional complaints. Jd. Upon examination, Holton’s blood oxygen
was normal, he was alert and oriented, and his lungs sounded clear
bilaterally. Id. Over the next week, medical staff followed up with

16

Holton several times and noted that he was asymptomatic, leading to
his release from isolation thereafter. Id. at 116.
Over the remainder of 2021, FCI Schuylkill medical professionals
examined Holton several times. Across these visits, Holton complained
of various symptoms, including breathing problems, eye problems, chest
pain, diarrhea, dizziness, rapid heartbeat, sleep disturbances, and joint
instability. Doc. 59-5 at 49-53, 55-59, 64, 73-75, 82-85, 153. As general
examinations performed at these visits failed to corroborate the alleged
severity of Holton’s symptoms, he was discharged with instructions to

manage his pain and without issue each time. Jd. Throughout this
period, medical records show that Holton continued to be treated for
anxiety and asthma. Jd. at 10—11, 18, 39, 59, 85, 149, 160, 192.
On February 8, 2022, Holton underwent an abdominal and pelvic
computed tomography scan. Among other things, it revealed “small
bilateral pleural effusions” (fluid in lungs) and “[m]inimal bibasilar
atelectasis” (collapsed lung). Doc. 59-6 at 154-55, 164-65, 172-73.
Holton was infected with COVID-19 a second time on July 26, 2022, and
recovered within ten days without developing any significant
symptoms. Id. at 10, 90.

17

On May 19, 2025, the United States deposed Holton. Doc. 59-3 at
1. In in his deposition, Holton clarified that the “pain of mind and body”
COVID-19 injuries he referenced in his complaint referred to partially
collapsed lungs with fluid buildup, asthma, deteriorating eyesight, and
“mental strain’—1.e., worsening depression, anxiety, and sleep
disturbances. Doc. 59-3 at 14-16, 21. Holton also confirmed that he was
originally diagnosed with asthma around 2012, and acknowledged that

no medical professional has ever attributed his anxiety or vision
problems to his 2021 COVID-19 infection. Id. at 31, 35-36. Holton
testified that his vision problems were caused by his COVID-19
infection because his vision “started getting blurred after” it, and he
claimed that “Dr. Bybel” at FCI Schuylkill explained that his collapsed
lung was a byproduct of his COVID-19 infection. Jd. at 17—20. Finally,
Holton claimed that a surgeon who operated on him for a hernia
recommended in December of 2021 that he be put on “some water pills”
for the fluid buildup in his lungs. Jd. at 24—25.
On June 24, 2025, defense expert Kenneth Rictor, M.D., generated
a report premised on his review of Holton’s medical records, allegations,
and deposition testimony. Doc. 59-8 at 2. In his report, Dr. Rictor

18

concluded that clinical records showed that Holton’s alleged injuries did
not “align with the typical diagnostic framework for Long COVID.” Id.
at 14. As explained by Dr. Rictor, the typical diagnostic framework of
Long COVID includes symptoms such as fatigue, dyspnea or shortness
of breath, chest pain or palpitations, sleep disorders, cognitive
disturbances known under the umbrella term “brain fog,” anxiety or
depression, myalgias or joint pain, and autonomic dysfunctions such as
postural tachycardia syndrome. Id. at 10-12.
Dr. Rictor found Holton’s alleged injuries inconsistent with the
above symptoms, saying that
The delayed findings of a partially collapsed lung and pleural
effusion nearly a year after infection are not consistent with
common pulmonary sequelae observed in Long COVID, which
tend to manifest within 3-6 months post-infection and are
often preceded by severe or hospitalized illness. Furthermore,
his pre-existing diagnosis of asthma, history of anxiety, and
age-related visual changes are more plausible explanations
for the symptoms he attributes to Long COVID.
The symptoms Mr. Holton later attributed to long COVID—
specifically a partially collapsed lung, pleural fluid, poor
eyesight, and ‘mental strain’—do not match the most common
or clinically accepted long COVID presentations. His asthma
was pre-existing, and the 2022 CT findings do not temporally
correlate with his 2021 COVID-19 illness. There is no
longitudinal clinical evidence linking these pulmonary
findings to sequelae of COVID-19.

19

Id. at 14.
Thus, Dr. Rictor ultimately concluded that “the available scientific
and clinical data support the conclusion that Mr. Holton’s complaints
are unrelated to COVID-19 and attributable to baseline comorbid
conditions such as asthma or anxiety, and not representative of long
COVID syndrome.” Id. at 15. Continuing his analysis, Dr. Rictor further
concluded that, contrary to Holton’s allegations,
The Bureau of Prisons met the standard of care in diagnosing
and managing Mr. Holton’s COVID-19 infection in early 2021.
Available treatment options were provided, and his symptoms
remained mild. No therapies known to reduce long COVID
risk were omitted. His later complaints, reviewed above, are
not medically attributable to the COVID infection based on
current evidence. Therefore, there is no clinical basis to
conclude a causal link between the 2021 COVID-19 infection
and his reported lingering symptoms.
Mr. Holton’s mild COVID-19 illness in March 2021 was
managed appropriately according to national standards. His
post-illness complaints do not conform to long COVID criteria,
and no medical evidence establishes a probable causal link
between his 2021 COVID-19 infection and later symptoms
such as partial lung collapse, poor eyesight, or anxiety.
Therefore, it is my opinion, to a reasonable degree of medical
certainty, that:
1. The BOP met the standard of care in evaluating and
managing Mr. Holton’s COVID-19 infection.
2. No viable therapeutic options were omitted that could have
altered the course of his illness.
3. Mr. Holton does not exhibit clinical evidence of long COVID.
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4. His reported ongoing symptoms are more likely
attributable to chronic co-morbidities or unrelated conditions
rather than sequelae of COVID-19.
Id. at 18. Holton does not offer any rebuttal expert report.
III. Discussion
A. Motion for Summary Judgment Standard
Summary judgment is appropriate only when record materials,
including but not limited to, “the pleadings, depositions, answers to
interrogatories, and admissions on file, together with the affidavits, if

any, show that there is no genuine issue as to any material fact and
that the moving party is entitled to judgment as a matter of law.”
Wishkin v. Potter, 476 F.3d 180, 184 (8d Cir. 2007); Fed. R. Civ. P. 56(a),
(c)(1)(A). In determining whether a genuine issue of material fact exists,
the court must view the evidence “in the light most favorable to the non-
moving party and must make all reasonable inferences in that party’s
favor.” Wishkin, 476 F.3d at 184.
A factual dispute is genuine “if the evidence is such that a
reasonable jury could return a verdict for the nonmoving party.”
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). And a fact is
material only if it “might affect the outcome of the suit under the

21

governing law... Id. But “a complete failure of proof concerning an
essential element of the nonmoving party’s case necessarily renders all
other facts immaterial.” Celotex Corp. v. Catrett, 477 U.S. 317, 323
(1986).
The movant “bears the initial responsibility of informing the
district court of the basis for its motion, and identifying those portions
of [the record, including but not limited to] the pleadings, depositions,
answers to interrogatories, and admissions on file, together with the
affidavits, if any, which it believes demonstrate the absence of a
genuine issue of material fact.” Id. “ ‘[T]he non-moving party must
[then] oppose the motion and, in doing so, may not rest upon the mere
allegations or denials of his pleadings’ but, instead, ‘must set forth
specific facts showing that there is a genuine issue for trial. Bare
assertions, conclusory allegations, or suspicions will not suffice.’ ”

Jutrowski v. Twp. of Riverdale, 904 F.3d 280, 288-89 (8d Cir. 2018)
(quoting D.E. v. Cent. Dauphin Sch. Dist., 765 F.3d 260, 268-69 (8d Cir.
2014)).
Even where, as here, the movant argues that the non-movant has
failed to produce sufficient evidence to prevail on a claim at trial, the

22

movant must still satisfy the initial burden of informing the court of the
basis for its motion. Celotex Corp., 477 U.S. at 323 (‘[A] party seeking
summary judgment always bears the initial responsibility of informing
the district court of the basis for its motion].]”). This means that
“lw]here the moving party does not have the burden of proof on the
relevant issues,” and they have pinpointed in their motion “deficiencies
in the opponent’s evidence” sufficient to show no reasonable jury could
return a verdict for the non-movant, they are entitled to “judgment as a
matter of law.” Anchorage Assocs. v. Virgin Islands Bd. of Tax Rev., 922
F.2d 168, 175 (8d Cir. 1990).
B. Holton’s Negligence Claims Under the FTCA
As previously construed by the Court, Holton’s complaint
advances claims for medical malpractice and ordinary negligence under
the FTCA. Doc. 1 at 1, 4-5. The FTCA is a limited waiver of sovereign
immunity that 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 United States 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.

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28 U.S.C. § 13846(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.”
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 United States in federal
court.” In re Orthopedic Bone Screw Prod. Liab. Litig., 264 F.3d 344,
862 (3d Cir. 2001). As such, FTCA claims require that courts “apply the
law of the state in which the act or omission occurred.” Hodge v. United
States Dep't of Justice, 372 F. App’x 264, 267 (38d Cir. 2010) (citing
Gould Elecs. Inc. v. United States, 220 F.3d 169, 179 (8d Cir. 2000)).
Thus, because the conduct giving rise to Holton’s claims occurred at FCI
Schuylkill, which lies within the Middle District of Pennsylvania,
Pennsylvania state law applies to his claims.
1. Medical Malpractice Claim
The United States seeks summary judgment on Holton’s medical
malpractice claim on the premise that he failed to obtain the expert
testimony necessary to establish a prima facie claim under

24

Pennsylvania law. Doc. 60 at 7-10. Holton contends in rebuttal that he

can make a prima facie showing of medical malpractice without an
expert, because “[t]he Court stated in it’s March 11, 2025 decision that,

a reasonable factfinder can find the defendants alleged failure to
‘properly [and] satisfactorily look into [the plaintiff's] complaint of Chest
Pain/Difficulty Breathing’ increased the risk of permanent [and]
prolonged symptoms.” Doc. 61-1 at 3 (errors in original). As the record
confirms that Holton has not produced the requisite expert testimony,
and cannot avail himself of the narrow exception to that requirement,
summary judgment on the professional negligence claim is warranted in
the United States’ favor.
Under Pennsylvania law, medical malpractice, or medical
negligence, is defined as “the unwarranted departure from generally
accepted standards of medical practice resulting in injury to a patient,
including all liability-producing conduct arising from the rendition of
professional medical services.” Toogood v. Owen J. Rogal, D.D.S., P.C.,
824 A.2d 1140, 1145 (Pa. 2008) (citing Hodgson v. Bigelow, 7 A.2d 338
(Pa. 1939)). It is not enough in medical malpractice cases to prove the
existence of an injury. Mitchell v. Shikora, 209 A.3d 307, 315 (Pa. 2019).

25

Rather, for a party to prevail in a medical malpractice action, it must
“establish the defendant owed a duty of care to the plaintiff, that duty .
was breached, the breach resulted in the plaintiffs injury, and the
plaintiff suffered an actual loss or damages.” Merlini ex rel. Merlini v.
Gallitzin Water Auth., 980 A.2d. 502, 506 (Pa. 2009) (citing Martin v.
Evans, 711 A.2d 458, 461 (Pa. 1998)). Plaintiffs bear the burden of proof
on these elements by a preponderance of the evidence. Rippee v. Grand
Valley Mfg. Co., 762 F.2d 25, 27 (8d Cir. 1985).
Critically, “to state a prima facie case of medical malpractice, a
plaintiff must provide a medical expert who will testify as to the
applicable standard of care (i.e. the duty) that the physician owed the
patient, that the physician breached that standard or duty, and that the
breach was the proximate cause of the harm suffered.” Miville v.
Abington Mem Hosp., 377 F.Supp.2d 488, 490-91 (E.D. Pa. 2005).
Pennsylvania law delineates the necessary qualifications to offer an
opinion as a medical expert in a malpractice action, providing that:
(a) General rule.—No person shall be competent to offer an
expert medical opinion in a medical professional liability
action against a physician unless that person possesses
sufficient education, training, knowledge and experience
to provide credible, competent testimony and fulfills the

26

additional qualifications set forth in this section as
applicable.
(b) Medical testimony.—An expert testifying on a medical
matter, including the standard of care, risks and
alternatives, causation and the nature and extent of the
injury, must meet the following qualifications:
(1)Possess an unrestricted physician’s license to practice
medicine in any state or the District of Columbia.
(2)Be engaged in or retired within the previous five
years from active clinical practice or teaching.
Provided, however, the court may waive the requirements
of this subsection for an expert on a matter other than the
standard of care if the court determines that the expert is
otherwise competent to testify about medical or scientific
issues by virtue of education, training or experience.
40 P.S. § 138038.512.
“The only exception to the requirement of expert testimony in
medical malpractice cases applies where the matter is so simple or the
lack of skill or care is so obvious as to be within the range of experience
and comprehension of even non-professional persons.” Miville, 377 F.
Supp. 2d at 491 n.2 (citing Hightower-Warren v. Silk, 698 A.2d 52, 54
n.1 (Pa. 1997)). This “very narrow exception” only applies, however,
“when the physician’s failure is clear even to a non-professional[,|”
meaning that the conduct and harm at issue must be so egregious that
they fall well outside the bounds of “a simple mistake of judgment,
27

failure of treatment, or an accidental occurrence.” Brown v. Hahnemann
Univ. Hosp., 20 F. Supp. 38d 538, 542-43 (E.D. Pa. 2014).
As previously construed by the Court, Holton’s medical
malpractice claim is premised on the contention that the medical
professionals at FCI Schuylkill owed Holton a duty to abide by
“senerally accepted medical standards.” Doc. 1 at 5; Doc. 52 at 6, 28. He

avers that this duty was breached when medical professionals at FCI
Schuylkill failed to test him for COVID-19 during his two medical visits

on February 22 and February 28, 2021, when he complained of COVID-
19 symptoms. Id.; Doc. 1 at 3-5. Holton, moreover, alleges that this
purported breach increased his risk of developing lingering and
permanent COVID-19 symptoms, which he claims he later developed.
Id. at 5; Doc. 52 at 28.
A review of the nature of Holton’s claim, coupled with the evidence
of record, concludes that the testimony of a medical expert is necessary
here to determine the precise contours of the alleged breach and
purported causation. The evidence shows that FCI Schuylkill medical
professionals rendered medical treatment to Holton on the dates in
question, see Doc. 59-5 at 103—05, and therefore, that they owed Holton

28

a duty of care to adhere to acceptable professional medical standards.
See Iwanejko v. Cohen & Grigsby, P.C., 249 F. App’x. 938, 944 (8d Cir.
2007) (concluding that, where medical treatment has been rendered,
medical malpractice claims ask whether that treatment “violated
acceptable professional standards|[.]”) (quotations omitted).
By contrast, the record is devoid of competent evidence
establishing that these medical professionals breached acceptable
professional medical standards by not testing Holton for COVID-19. A
review of Holton’s deposition reveals that he made a single potential
reference to an alleged breach of the duty of care owed to him by FCI
Schuylkill’s medical professionals, testifying that he suffered mental
strain as a result of “[p]retty much the things that I went through when
I had COVID, far as, like not getting the adequate treatment that I may
have thought I deserved.” Doc. 59-3 at 21. It is unclear whether that
testimony specifically referenced Holton’s medical visits in February
2021, or whether the treatment sought was a COVID-19 test.
Even construing that testimony in Holton’s favor, however, no
expert opinion in the record supports his contention that failing to test
him for COVID-19 was a breach of a professional duty. Moreover,

29

Holton’s testimony alone is insufficient to create a genuine, material
factual dispute, because he does not possess the qualifications necessary
under Pennsylvania law to testify before a factfinder on the subjects of
professional medical duty and breach. See Maresca v. Mancall, 135 F.
App’x. 529, 531 (8d Cir. 2005) (“In the absence of such [expert]
testimony, the District Court was bound to grant judgment as a matter
of law in the Defendants’ favor.”); 40 P.S. § 18038.512.
Furthermore, the expert testimony exception does not apply here,
because “the conduct at issue constituted an integral part of rendering
medical treatment, and involved” complicated, multi-faceted medical
questions involving “diagnosis, care, and treatment by a licensed
professional|.]” Paige v. Holizapple, 2009 WL 2588849, at *4 (M.D. Pa.
2009). Thus, to avoid a factfinder employing “conjecture, surmise[,] or
speculation” to determine if the conduct at issue breached a professional
medical duty, Toogood, 824 A.2d at 1145, Holton was required to
produce his own supporting expert testimony. His failure to do so
precludes him from succeeding on his medical negligence claim. See
Maresca, 135 F. App’x. at 531 (“In the absence of such [expert]

30

testimony, the District Court was bound to grant judgment as a matter
of law in the Defendants’ favor.”); 40 P.S. § 1803.512.
Even if a material issue existed for breach, Holton’s medical
malpractice claim would not survive summary judgment on causation.
The record is devoid of competent evidence establishing that FCI
Schuylkill medical professionals’ failure to test Holton for COVID-19 in
February 2021 caused his alleged lingering injuries. Rather, the only
competent evidence in the record on the subject of causation lies in the
expert report authored by Dr. Rictor on behalf of the United States.
Dr. Rictor’s expert report refuted the allegations of causation in
Holton complaint, opining that “[t]he symptoms Mr. Holton later
attributed to long COVID—specifically a partially collapsed lung,
pleural fluid, poor eyesight, and ‘mental strain—do not match the most

common or clinically accepted long COVID presentations.” Doc. 59-8 at
14. Rather, Dr. Rictor found that “[Holton’s] pre-existing diagnosis of
asthma, history of anxiety, and age-related visual changes are more
plausible explanations for the symptoms... .” Id. Dr. Rictor thus
concluded that, “no medical evidence establishes a probable causal link
between [Holton’s] 2021 COVID-19 infection and later symptoms such

31

as partial lung collapse, poor eyesight, or anxiety[,]” and “to a
reasonable degree of medical certainty, that” “[Holton’s] reported
ongoing symptoms are more likely attributable to chronic co-morbidities

or unrelated conditions rather than sequelae of COVID-19.” Jd. at 18.
The competing evidence in the record arises from Holton’s
deposition testimony and record evidence that he highlights. Holton
testified that “Dr. Bybel” at FCI Schuylkill explained that his collapsed
lung was a byproduct of his COVID-19 infection. Doc. 59-3 at 17-20.
Holton, however, does not offer any testimony from Dr. Bybel. Thus,
Holton’s testimonial statement that Dr. Bybel explained that Holton’s
collapsed lung was a byproduct of his COVID-19 infection is not
competent evidence of causation. As Holton would need to offer this out-
of-court statement into evidence at trial to “prove the truth of the”
causal matter it asserts, and because Dr. Bybel is the declarant, the
statement is hearsay under Fed. R. Evid. 801. Hearsay, cannot be
considered at the summary judgment stage, unless the “nonmoving
party explains that it can be produced in an admissible form at trial.”
Travillion v. Wetzel, 2025 WL 971669, at *3 (8d Cir. 2025) (citing
Fraternal Order of Police, Lodge 1 v. City of Camden, 842 F.3d 231,

32

238-39 (3d Cir. 2016)). Thus, because Holton has failed to explain how
this hearsay statement can be produced in admissible form at trial, it
“may not be considered for purposes of summary judgment.” Smith v.
City of Allentown, 589 F.3d 684, 693 (8d Cir. 2009).
Holton also testified that COVID-19 caused his vision problems,
because his vision “started getting blurred after” his COVID-19
infection. Doc. 59-3 at 17—20. He further cites portions of the record that
the undersigned construes as attempts to refute Dr. Rictor’s expert
opinion on the issue of causation.
First, Holton disputes Dr. Rictor’s conclusion that medical records
do not show that Holton exhibited hallmark Long COVID symptoms
“such as fatigue, cognitive dysfunction etc.” Doc. 61-1 at 3. In response,
Holton highlights medical records from 2021 that he contends show he
suffered from such hallmark symptoms. Jd. And indeed, a review of the
2021 medical records Holton cites to shows that, in at least one instance

on July 22, 2021, FCI Schuylkill medical staff found that Holton
reported the “hallmark” Long COVID symptom of fatigue. Doc. 61-2 at
23.

33

Second, Holton disputes Dr. Rictor’s conclusion that Holton’s
respiratory “complaints may be confounded by his chronic asthma &
tobacco use.” Doc. 61-1 at 3. Holton counters this conclusion by
asserting that he has “never smoked a day in his life,” and he flags
medical records from 2021 that he contends show that his respiratory
complaints were a result of COVID-19. Jd. Again, a review of these
records shows that, in at least one instance on March 26, 2021, FCI
Schuylkill medical staff noted in an encounter with Holton that he was
“aware that recovery from COVID” and building his respiratory
capacity back up for exercise purposes “may take some time.” Doc. 61-3
at 1.
But neither Holton’s testimony concerning his blurry vision, nor
the medical records he cites, are accompanied by any interpretive
expert testimony that directly refutes Dr. Rictor’s conclusion that
Holton’s injuries were not caused by his COVID-19 infection, as
required under 40 P.S. § 1303.512. Thus, this evidence shows only that
Holton’s vision “started getting blurred” sometime after his COVID-19
infection, and, likewise, that Holton was reported as having fatigue and

a diminished respiratory capacity sometime after his COVID-19

34 □

infection. Even viewed in the light most favorable to Holton, however,
‘this evidence only establishes correlation with Holton’s COVID-19
infection, not that his injuries of a collapsed lung, pleural fluid, poor
eyesight, and ‘mental strain,’ were caused by his COVID-19 infection;
the precise analysis for which expert testimony is required. See
Maresca, 185 F. App’x. at 531. Accordingly, Holton has not “overcome
his own hurdle in order to withstand the motion for summary
judgment.” D.E., 765 F.3d at 268.
Although Holton seeks to survive summary judgment: by
leveraging the Court’s decision on the United States’ motion for
judgment on the pleadings, Doc. 52, that reliance is misplaced.
Claiming that he can make a prima facie showing of medical
malpractice without expert testimony, Doc. 61-1 at 3, Holton cites the
Court’s statement that “a reasonable factfinder could find the
defendant’s alleged failure to properly & satisfactorily look into [the
plaintiff's] complaint of Chest Pain/Difficult Breathing increased the
risk of permanent and prolonged symptoms[,]” and that “[t]he plaintiff
has pled sufficient facts to support his ordinary and professional
negligence claims for his prolonged and permanent COVID-19

35

symptoms[.]” Doc. 52 at 23-24. What Holton overlooks, however, was
the Court’s emphasis that its ruling was premised solely on the
allegations in the pleadings, and forewarning that its “holding .. . does
not excuse the plaintiffs burden in proving the requisite elements of a
medical malpractice claim, including potential testimony from a
medical expert to prevail on that claim... . [and] does not impact the
potential viability of the defendant’s contention that the plaintiff needs
to present expert testimony to ultimately prevail on his claim.” Id. at 24
n.9. Holton fails to carry that burden here, despite having been put on
notice that expert testimony was potentially integral to pursue his
claim past the pleadings stage.
Accordingly, as Holton has not offered any expert evidence to
create a genuine issue of fact concerning his professional negligence
claim, and no reasonable factfinder could find that the United States
committed medical malpractice based on the existing record, summary
judgment is warranted.
2. Ordinary Negligence Claim
The United States requests summary judgment on the grounds
that there is insufficient record evidence to support a finding that its

36

conduct breached an ordinary duty of care. Doc. 60 at 9-18. In the
alternative, the United States avers that Holton cannot establish
through record evidence that any breach caused an increased risk of
long-term COVID-19 complications. Jd. at 13-15. Holton contends in
rebuttal that he has “successfully pled adequate facts to show a nexus
between his lingering [and] permanent symptoms” of COVID-19 and the
United States’ conduct, claiming that “[g]eneral delays in treatment for
illnesses can certainly embody causation for injuries separate from the
illness itself[.]” Doc. 61-1 at 3. As the record evidence does not evince a
disputed issue concerning whether prison staff breached a duty of care,

summary judgment is warranted in the United States’ favor.
Under Pennsylvania law, a plaintiff must prove the following
elements to establish a prima facie claim for negligence: “(1) the
defendant had a duty to conform to a certain standard of conduct; (2)
the defendant breached that duty; (3) such breach caused the harm in
question; and (4) the plaintiff incurred actual loss or damage.” Kreniz v.
Consol. Rail Corp., 910 A.2d 20, 27 (Pa. 2006). The plaintiff bears the
burden of proving these elements by a preponderance of the evidence.
Rippee, 762 F.2d at 27.

37

As previously construed by the Court, Holton’s ordinary
negligence claim is premised on two interrelated contentions. First, that
the staff at FCI Schuylkill owed Holton a duty to provide him with
“suitable quarters [and] provide” for his “safekeeping[] [and] car[e]”
pursuant to 18 U.S.C. § 4042. Doc. 1 at 5; Doc. 52 at 6-7, 23. Second,
that this duty was breached when medical professionals at FCI
Schuylkill allegedly failed to “properly and satisfactorily look into” his
“complaint of Chest Pain/Difficultly Breathing” during his medical
visits on February 22 and 23, 2021, and during his subsequent
quarantine after testing positive for COVID-19 from March 8 to 15 of
2021. Id.; Doc. 1 at 3-5. Holton, moreover, alleges that this purported
breach increased his risk of developing lingering and permanent
COVID-19 symptoms, which he claims he later developed. Jd. at 5; Doc.
52 at 23.
The duty at issue is set by federal statute, which provides that the
United States has a duty to “provide suitable quarters and provide for
the safekeeping, care, and subsistence of all persons charged with or
convicted of offenses against the United States, or held as witnesses or
otherwise].]” 18 U.S.C. § 4042(a)(2). Thus, as a federal prisoner at FCI

38

Schuylkill, the United States owed Holton a duty of “ordinary diligence
to keep [him] safe from harm.” Hossic v. United States, 682 F.Supp. 23,
25 (M.D. Pa. 1987); Balter v. United States, 2014 WL 1865905, at *26
(M.D. Pa. 2014) (“The duty of care as provided by 18 U.S.C. § 4042 is
that of ordinary diligence to keep prisoners safe from harm.”) (internal
quotations omitted).
In his claim, Holton alleges that medical professionals at FCI
Schuylkill breached this duty of ordinary diligence when they failed to
sufficiently evaluate his complaints of chest pain and difficulty
breathing on February 22 and 23, 2021, and during his subsequent
quarantine after testing positive for COVID-19 from March 8 to 15 of
2021. Doc. 1 at 8-5. “Courts of the Third Circuit, in limited
circumstances, have recognized that certain acts or omissions by prison
medical staff can constitute a breach of an ordinary negligence duty.”
Grundowski v. United States, 2012 WL 1721781, at *6 (M.D. Pa. 2012)
(emphasis added). The recognized limited circumstances have included
prison staff failing to treat an inmate’s diabetes, see id. at *10; prison
staff denying an inmate their prescribed medication, see Jones v. United
States, 91 F.3d 628, 625 (8d Cir. 1996); prison staff failing to treat an

39

inmate for dental problems, see Hill v. Lamanna, 2006 WL 2433778, at
*9 (W.D. Pa. 2006); and prison staff failing to schedule an inmate for

necessary medical treatment in a timely fashion, see Aviles v. United
States, 2012 WL 3562370, at *6 (E.D. Pa. 2012). In other words, general
failures to provide or provide access to medical treatment that do not
“involve an issue of medical judgment,” the latter of which lie
appropriately in medical malpractice claims. Grundowski, 2012 WL
1721781, at *6.
A review of the record finds insufficient evidence for a factfinder to
conclude that the United States’ conduct breached its duty under 18
U.S.C. § 4042. Record evidence corroborates Holton’s claim that he was
examined by FCI Schuylkill medical staff on February 22 and 23 of
2021 for both chest pain and difficulty breathing. Doc. 59-5 at 103-05.
Additionally, record evidence confirms that at least once during
Holton’s isolation for COVID-19, he complained to medical staff that he
had intermittent shortness of breath. Id. at 87.
The record also reveals, however, that Holton underwent
examinations for these complaints, except for his February 22, 2021,
visit, when Holton instead elected to terminate the encounter with

40

medical staff before an examination could be conducted. Jd. at 105. The
two examinations that Holton underwent, conducted on February 24,
2021, and March 8, 2021, show that although Holton complained of
difficulties breathing and chest pains, his vital signs were normal, such

as his heart rate, temperature, oxygen saturation level, and his lung
sounds. Id. at 87-88, 1038—04. Furthermore, an electrocardiogram
(“EKG”) taken on February 24, 2021, showed unremarkable findings.
Id. at 104, 228.
Notwithstanding these exam results, Holton contends that staff
should have done more for him, and that their corresponding failure
constitutes breach. In particular, Holton testified that “[p]retty much
the things that I went through when I had COVID, far as, like not
getting the adequate treatment that I may have thought I deserved.”
Doc. 59-3 at 21. Holton does not, however, offer any record evidence,
and the undersigned has not identified any, showing that prison
medical staff failed to provide Holton with medical treatment, or
delayed any necessary medical treatment.
To the contrary, record evidence shows that, on the relevant dates
where Holton complained of chest pain and difficulties breathing,

4]

medical staff, when allowed the opportunity, examined Holton and
treated him for his complaints. Doc. 59-5 at 87-88, 103-04. On
February 22, 2021, when Holton complained about “the same chest pain
he was having before when he went to the hospital in November|]”
2020, medical staff reviewed the hospital records with Holton, noting
that the hospital found his chest pain to be musculoskeletal and that
his EKG findings were normal, before he ended the encounter. Jd. at
105. The following day, when Holton again complained of chest pain
and difficulty breathing, medical staff performed a general exam and an
EKG, both of which showed no abnormalities. Id. at 103—04, 228.
Medical staff thereafter recommended that Holton continue taking his
medications and seek further treatment if his condition worsened. Id. at
88, 104.
Similarly, while Holton remained in quarantine following his
positive COVID-19 test in March 2021, medical staff monitored him and
took his temperature several times over the ensuing days. Doc. 61-1 at
116. On March 8, 2021, when Holton reported intermittent shortness of
breath and a non-productive cough, medical staff conducted an
examination, finding that Holton’s blood oxygen was normal, he was

42

alert and oriented, and his lungs sounded clear bilaterally. Jd. at 87.
Over the next week, medical staff followed up with Holton several times
and noted that he was asymptomatic, leading to his release from
isolation thereafter. Id. at 116.
Nothing in the record evinces any refusal to administer, or delays
in administering medical treatment, and Holton does not identify any
evidence corroborating his claims. Jd. Nor does he explain, through
evidence or otherwise, how the treatment he received was flawed or
delayed, or what additional treatment he should have received, but did
not. At most, Holton offers only his deposition testimony, in which he
claimed that he did not receive “adequate treatment,” and that an
unspecified time, he did not receive “diuretics .. . water pills for the
fluid in the lungs.” Doc. 59-3 at 21, 23. That testimony, bereft of any
corroborating medical records, cannot create a disputed issue of fact in
consideration of the medical evidence provided by the United States
that refutes any claimed breach of duty.
Indeed, Dr. Rictor’s expert report concluded that, even if Holton
had required additional COVID-19 treatment, staff had no ability to
provide it for him, because “[a]s of early 2021, no preventive therapies

48

had been validated to mitigate the risk of Long COVID in asymptomatic
or mild cases. Accordingly, the care provided by the BOP did not deviate
from standard practice... .” Doc. 59-8 at 15.
Here, the evidence of record shows that Holton received consistent
treatment from prison medical staff in response to his complaints.
Although Holton concludes that this treatment was inadequate, the
record contains no evidence corroborating his claims. Holton thus has
failed to demonstrate a disputed issue of material fact concerning
whether the United States breached its duty of care. Accordingly,
summary judgment on Holton’s ordinary negligence claim is warranted
in the United States’ favor.

2 As the undersigned recommends granting summary judgment on the element of
breach, there is no need to address the parties’ contentions concerning causation.
That said, the causation inquiry may well present a disputed issue of fact that
cannot be determined on summary judgment. The United States relies on Dr.
Rictor’s opinion that Holton’s injuries are incompatible with the medical condition
known as Long COVID. Id. at 18-14. The United States also contends that record
evidence evinces that Holton’s preexisting asthma and anxiety are the causes of his
claimed injuries. Jd. at 14-15. In response, Holton offers both his competing
testimony and medical records that show at least potential correlation, if not
causation, between his COVID-19 infections and subsequent symptoms, including
statements from FCI Schuylkill medical staff in March and July of 2021, indicating
that Holton might suffer from Long COVID symptoms. See Doc. 59-3 at 17-20, Doc.
61-1 at 2-4; Doc. 61-2 at 23; Doc. 61-3 at 1. As expert testimony is not required for
an ordinary negligence claim, Holton’s evidentiary showing on causation indicates a
disputed issue of material fact. Jutrowski, 904 F.3d at 289.
44

IV. Recommendation
For the reasons set forth above, it is RECOMMENDED that:
1. The Defendant’s motion for summary judgment (Doc. 58) be
GRANTED, and all remaining claims and defendants be
DISMISSED WITH PREJUDICE; and
2. The Clerk’s Office be DIRECTED to TERMINATE the
United States of America as Defendant and CLOSE this

case.
The parties are further placed on notice that pursuant to Local
Rule 72.3:
Any party may object to a magistrate judge’s proposed
findings, recommendations or report addressing a motion or
matter described in 28 U.S.C. § 636 (b)(1)(B) or making a
recommendation for the disposition of a prisoner case or a
habeas corpus petition within fourteen (14) days after being
served with a copy thereof. Such party shall file with the clerk
of court, and serve on the magistrate judge and all parties,
written objections which shall specifically identify the
portions of the proposed findings, recommendations or report
to which objection is made and the basis for such objections.
The briefing requirements set forth in Local Rule 72.2 shall
apply. A judge shall make a de novo determination of those
portions of the report or specified proposed findings or
recommendations to which objection is made and may accept,
reject, or modify, in whole or in part, the findings or
recommendations made by the magistrate judge. The judge,
however, need conduct a new hearing only in his or her
discretion or where required by law, and may consider the
45

record developed before the magistrate judge, making his or
her own determination on the basis of that record. The judge
may also receive further evidence, recall witnesses or
recommit the matter to the magistrate judge with
instructions.
M.D. Pa. L. R. 72.8. The failure to file timely objections to the foregoing
Report and Recommendation may constitute a waiver of any appellate
rights. See Nara v. Frank, 488 F.3d 187, 194 (8d Cir. 2007).

Date: February 3, 2026 s/ Phillip J. Caraballo
Phillip J. Caraballo
United States Magistrate Judge

46

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11304819. Public record. Not legal advice.