RUIZ v. ALDRIDGE

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UNITED STATES DISTRICT COURT FOR THE
NORTHERN DISTRICT OF FLORIDA
PENSACOLA DIVISION
JULIO RODRIGUEZ RUIZ,
Plaintiff,
vs. 	Case No.: 3:24cv260/TKW/ZCB
BEAU ANTHONY ALDRIDGE,
Defendant.
____________________________________/
REPORT AND RECOMMENDATION
Plaintiff is a Florida prisoner proceeding 	pro se 	and 	in forma
pauperis in this civil action. 	(Doc. 1). 	Defendant filed a motion to
dismiss, and Plaintiff responded in opposition. (Docs. 49, 62). The Court
held a hearing and deferred ruling on Defendant’s motion until the
parties had an opportunity to file supplemental briefs addressing the
Supreme Court’s recent decision in Berk v. Choy, 146 S. Ct. 546 (2026).
(Docs. 66, 67). 	The supplemental briefs have now been filed. 	(Docs. 69,
75). 	For the reasons below, Defendant’s motion to dismiss should be
denied in part and granted in part.
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I. 	Plaintiff’s Factual Allegations1
Plaintiff’s complaint names one Defendant, Dr. Beau Aldridge, a
surgeon at Baptist Hospital. 	(Doc. 1 at 1-2). 	According to Plaintiff’s
allegations, Baptist Hospital entered into a contract to provide outside
medical services to Florida Department of Corrections inmates housed at
Blackwater River Correctional Facility. (Id. at 9).
In 2005, Plaintiff had a hernia surgery that resulted in the insertion
of hernia mesh. In 2022, Plaintiff was incarcerated at Blackwater River
when he contracted an infection that spread to his stomach and the
hernia mesh. 	(Id. at 6). 	The prison physician ordered that Plaintiff be
transported to Baptist Hospital for treatment on January 21, 2022. (Id.).
Once at Baptist Hospital, Plaintiff was examined by Defendant who
determined surgery was necessary. (Id.).
That same day, Defendant performed the surgery. (Id.). According
to Plaintiff, Defendant knew that Plaintiff would experience substantial
suffering if Defendant did not remove the hernia mesh, clean out the
infection, and implant new mesh. 	(Id. at 6-7). 	Nonetheless, Plaintiff
1 At the motion to dismiss stage, the Court accepts the allegations as true.
Gundy v. City of Jacksonville, Fla., 50 F.4th 60, 69 (11th Cir. 2022).
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claims that Defendant did not clean out all the infection and did not
remove and replace the mesh. 	(Id. at 7). 	Defendant instead left the
infected mesh in place, even though he allegedly knew that failing to
remove the mesh would cause Plaintiff to “suffer substantially[.]” 	(Id.).
Plaintiff was discharged back to Blackwater River the same day as the
surgery. (Id.).
Plaintiff spent the next five months or so in Blackwater River’s
infirmary. 	(Id. at 7). 	During his stay in the infirmary, prison medical
staff noticed an odorous liquid oozing from the surgical site. 	(Id.). 	Lab
tests and x-rays performed by the prison medical staff confirmed a
bacterial infection. 	(Id.). 	The prison physician prescribed Plaintiff
antibiotics to treat the infection. (Id.). Ultimately, the infection resulted
in Plaintiff being transported back to Baptist Hospital on June 9, 2022,
for a second surgery by Defendant. (Id.).
According 	to 	Plaintiff’s 	allegations, 	during 	the 	second 	surgery
Defendant again left in the infected hernia mesh. 	(Id.). 	Defendant
allegedly 	did 	that, 	even 	though 	he 	knew 	it 	would 	cause 	Plaintiff
additional suffering. 	(Id.). 	Defendant discharged Plaintiff back to
Blackwater River the same day as the surgery. (Id.).
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Once 	back 	at 	Blackwater 	River, 	Plaintiff 	developed 	another
infection. 	(Id.). 	So, on November 8, 2022, the prison physician sent
Plaintiff to Baptist Hospital for a third surgery by Defendant. (Id.). This
time, Defendant allegedly inserted a second mesh. (Id.). But he still left
in the infected first mesh, even though Defendant allegedly knew that
this would result in the second mesh becoming infected and would cause
Plaintiff more pain and suffering. (Id.).
After the third surgery, Defendant discharged Plaintiff back to
Blackwater River. At the time of this discharge, Defendant allegedly told
Plaintiff that he would remove the first mesh in two weeks. 	(Id. at 8).
When Plaintiff returned to Baptist Hospital, however, Defendant did not
remove the mesh as promised. 	(Id.). 	Instead, Defendant left the mesh
inside Plaintiff, and he allegedly did so with knowledge that it “would
cause Plaintiff more suffering.” (Id.).
Plaintiff subsequently requested that the prison transfer him to the
FDOC’s Reception and Medical Center for evaluation and treatment.
(Id.). That request was approved, and in December of 2022 Plaintiff was
transferred to the Reception and Medical Center. 	(Id.). 	Plaintiff was
then sent from the Reception and Medical Center to Memorial Hospital,
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where he was operated on by Dr. Anand Gupta. 	(Id.). 	In a four-hour
surgery on August 10, 2023, Dr. Gupta removed the infected mesh,
cleaned the infected areas, removed and repaired a section of Plaintiff’s
intestines, and inserted a clean replacement mesh. 	(Id.). 	According to
Plaintiff, Dr. Gupta said that Defendant’s failure to remove the infected
mesh caused Plaintiff’s pain and suffering. 	(Id. at 8-9). 	Dr. Gupta also
allegedly said that the three surgeries completed by Defendant were so
ineffective that Plaintiff became resistant to antibiotics, which resulted
in large, painful boils on his body. (Id. at 9).
According 	to 	the 	complaint, 	Defendant’s 	conduct 	violated 	the
Eighth Amendment. 	(Id. at 12). 	In terms of relief, Plaintiff seeks
nominal, compensatory, and punitive damages. (Id. at 11-12).
II. 	Discussion
Defendant has moved to dismiss the complaint under Rule 12(b)(6)
of the Federal Rules of Civil Procedure. 	(Docs. 49, 69). 	To survive
dismissal under Rule 12(b)(6), “a complaint must contain sufficient
factual matter, accepted as true, to state a claim to relief that is plausible
on its face.” 	Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (cleaned up). In
addition to accepting all facts as true, at the motion to dismiss stage the
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Court is also required to “draw all reasonable inferences in the plaintiff’s
favor.” Sebastian v. Ortiz, 918 F.3d 1301, 1307 (11th Cir. 2019). Because
Plaintiff 	is 	proceeding 	pro 	se, 	the 	Court 	is 	required 	to 	“liberally
construe[]” his claims and to hold him to “less stringent standards than
formal pleadings drafted by lawyers.” 	Erickson v. Pardus, 551 U.S. 89,
94 (2007).
Here, Defendant makes two arguments in favor of dismissal. First,
Defendant argues that Plaintiff’s complaint should be construed as
raising a medical malpractice claim, as opposed to an Eighth Amendment
deliberate indifference claim. 	And Defendant says that such a medical
malpractice claim is subject to dismissal because Plaintiff failed to follow
Florida’s presuit requirements. 	Second and alternatively, Defendant
argues that if Plaintiff’s claim is construed as raising a deliberate
indifference claim, then it is subject to dismissal for failure to state a
claim.
A.
Turning to the first argument, Defendant asserts that although
Plaintiff 	has 	styled 	his 	claim 	as 	an 	Eighth 	Amendment 	deliberate
indifference claim it is actually a medical malpractice claim. (Doc. 49 at
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8-9). 	Defendant then argues that once properly construed as a medical
malpractice claim, dismissal is appropriate because Plaintiff has failed
to comply with the presuit requirements found in Chapter 766 of the
Florida Statutes. (Id.). The Court disagrees with Defendant’s assertion
that Plaintiff has brought a medical malpractice claim instead of a
deliberate indifference claim.
A review of the complaint reveals that Plaintiff has asserted an
Eighth Amendment deliberate indifference claim and not a state medical
malpractice claim. 	The introduction section of the complaint begins by
stating that “this civil rights action is filed . . . under 42 U.S.C. § 1983,
alleging deliberate indifference to Plaintiff’s serious medical needs and
reckless disregard and wanton infliction of substantial pain.” 	(Doc. 1 at
5). Both the factual summary as well as the statement of claims also use
the 	language 	of 	a 	deliberate 	indifference 	claim. 	For 	example, 	the
complaint says Defendant acted with “reckless disregard,” (id. at 8), it
alleges a serious medical need (id. at 6), it alleges that Defendant acted
with knowledge that his actions would cause pain and suffering to
Plaintiff (id. at 7), it has a heading titled “deliberate indifference” (id. at
6), it states that Defendant’s actions were “reckless and deliberately
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indifferent to Plaintiff’s serious medical needs” (id. at 12), it accuses
Defendant of acting with “reckless disregard for Plaintiff’s constitutional
right” (id.), it specifically cites the Eighth Amendment (id.), and it
contains an explanation as to why Defendant acted under color of state
law—something that would not be required for a medical malpractice
claim (id. at 9). Accordingly, the Court finds that Plaintiff has brought a
deliberate indifference claim under the Eighth Amendment and not a
state law medical malpractice claim.2
2 In reaching this conclusion, the Court did not overlook the fact that in
Plaintiff’s response to the motion to dismiss he stated that his complaint
“styled his claim as one under 1983 for deliberate indifference,” and he
requested that the Court “order the correction of medical malpractice-not
deliberate indifference.” 	(Doc. 62 at 7). 	That statement has no bearing
on whether Plaintiff asserted a deliberate indifference claim in his
complaint because a district court’s “review on a motion to dismiss is
limited to the four corners of the complaint.” Wilchombe v. TeeVee Toons,
Inc., 555 F.3d 949, 959 (11th Cir. 2009) (cleaned up). If Plaintiff wished
to modify the claims raised in his complaint, then he would have had to
file an amended complaint. He did not do so. Thus, the Court’s decision
on the motion to dismiss is based on the text of the allegations found in
Plaintiff’s complaint. 	See Burgess v. Religious Tech. Center, Inc., 600 F.
App’x 657, 665 (11th Cir. 2015) (“We repeatedly have held that plaintiffs
cannot 	amend 	their 	complaint 	through 	a 	response 	to 	a 	motion 	to
dismiss.”). 	For what it is worth, the Court would note that in Plaintiff’s
supplemental response to the motion to dismiss he cited 42 U.S.C. § 1983
and referred to his claim as one of “deliberate indifference . . . caused by
medical malpractice.” 	(Doc. 75 at 2). 	It appears to the Court that
Plaintiff—a pro se litigant, with little education, and limited English
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B.
The Court will now discuss whether the deliberate indifference
claim in Plaintiff’s complaint has been plausibly alleged. 	The Eighth
Amendment forbids the “inflict[ion]” of “cruel and unusual punishments.”
U.S. Const. amend. VIII. It is “cruel and unusual punishment” for prison
officials to act with “deliberate indifference to serious medical needs of
prisoners[.]” 	Estelle v. Gamble, 429 U.S. 97, 104 (1976). 	That means
prison 	officials 	are 	obligated 	to 	provide 	prisoners 	with 	“minimally
adequate medical care[.]” 	Harris v. Thigpen, 941 F.2d 1495, 1504 (11th
Cir. 1991).
A deliberate indifference claim requires the satisfaction of two
prongs—one objective, one subjective. 	Farrow v. West, 320 F.3d 1235,
1243 (11th Cir. 2003). 	At the motion to dismiss stage, satisfying the
objective prong requires a plaintiff to plausibly allege an “objectively
serious medical need[.]” 	Keohane v. Fla. Dep’t of Corr. Sec’y, 952 F.3d
proficiency—at times has been imprecise in his terminology or has been
confused by the nuances between different legal claims. 	And that, of
course, is why pro se pleadings are liberally construed and held to a less
stringent standard than pleadings drafted by attorneys. Tannenbaum v.
United States, 148 F.3d 1262, 1263 (11th Cir. 1998).
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1257, 1266 (11th Cir. 2020) (cleaned up). 	A medical need is objectively
serious if it “has been diagnosed by a physician as mandating treatment
or [is] one that is so obvious that even a lay person would easily recognize
the necessity for a doctor’s attention—that, if left unattended, poses a
substantial risk of serious harm.” 	Id. (cleaned up). 	To satisfy the
subjective prong at the motion to dismiss stage, a plaintiff must plausibly
allege that the defendant acted with “subjective recklessness as used in
the criminal law.” Bayse v. Ward, 147 F.4th 1304, 1311 (11th Cir. 2025).
This means that the plaintiff must plausibly allege that “the defendant
was 	actually, 	subjectively 	aware 	that 	his 	own 	conduct 	caused 	a
substantial risk of serious harm to the plaintiff.” 	Gantt v. Everett, 162
F.4th 1107, 1111 (11th Cir. 2025).
Having closely examined the complaint, the Court finds that the
allegations 	are 	sufficient 	to 	state 	a 	plausible 	Eighth 	Amendment
deliberate indifference claim. 	First, Plaintiff has plausibly alleged an
objectively serious medical need. 	According to the complaint, Plaintiff
had 	a 	severe 	abdominal 	infection 	that 	required 	multiple 	surgeries,
antibiotics, and extended stays in the prison infirmary. 	The complaint
further alleges that the infection and resulting surgeries caused Plaintiff
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pain and discomfort. 	These allegations are sufficient to plausibly allege
an objectively serious medical need, which is the first requirement for a
deliberate indifference claim.
Second, Plaintiff has plausibly alleged that Defendant acted with
subjective recklessness. 	In other words, the complaint has plausibly
alleged that Defendant was aware that his conduct posed a substantial
risk of serious harm to Plaintiff yet he undertook it anyway. 	According
to the complaint, Defendant knew that Plaintiff had a serious infection
involving his hernia mesh. (Doc. 1 at 6-7). Defendant also allegedly knew
that Plaintiff would “suffer substantially” unless the area was cleaned
and the infected mesh replaced with new sterilized mesh. 	(Id.). 	The
complaint further alleges that despite having that knowledge, Defendant
(on three separate occasions) left the infected mesh in place and did so
“knowing this would cause Plaintiff great suffering.” (Id. at 7).
It is also alleged that Defendant promised to take the mesh out
several weeks after the second surgery, but he failed to do so even though
he knew “his failures would cause Plaintiff more suffering.” 	(Id. at 8).
And Plaintiff has specifically alleged that 	Defendant’s conduct 	was
undertaken 	with 	“reckless 	disregard” 	for 	Plaintiff’s 	serious 	medical
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needs. 	(Id. at 8). 	The complaint also alleges that—because Plaintiff
continued to experience symptoms of infection despite the three surgeries
performed by Defendant—he was transported to a different hospital for
surgery by a different surgeon, Dr. Gupta. 	According to Plaintiff, Dr.
Gupta removed the infected mesh, cleaned the area, and inserted new
sterile mesh. 	Moreover, Dr. Gupta allegedly opined that Defendant’s
conduct caused Plaintiff to experience “substantial pain and suffering.”
(Id. at 8-9).
These allegations—accepted as true, construed liberally, and with
all reasonable inferences drawn in Plaintiff’s favor—are sufficient to
“nudge” Plaintiff’s deliberate indifference claim “across the line from
conceivable to plausible.” Holland v. Carnival Corp., 50 F.4th 1088, 1093
(11th Cir. 2022). Discovery may show that what Plaintiff says happened
did not actually happen, but for purposes of surviving a motion to dismiss
Plaintiff’s allegations are sufficient. 	Accordingly, Defendant’s motion to
dismiss Plaintiff’s deliberate indifference claim should be denied.
C.
Although 	the 	Court 	does not 	believe 	that 	Plaintiff asserted a
medical malpractice claim in the complaint, to the extent the complaint
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could be construed as raising both a deliberate indifference claim and a
medical malpractice claim, the medical malpractice claim would be
subject to dismissal. That is because Plaintiff has not alleged satisfaction
of the presuit requirements for medical malpractice claims under Fla.
Stat. § 766.106.
Under Florida law, before filing any medical malpractice claim a
plaintiff must send the defendant a notice of intent to sue, along with a
corroborating opinion by a medical expert. Fla. Stat. §§ 766.106, 766.203.
These 	requirements 	are 	conditions 	precedent 	to 	filing 	a 	medical
malpractice claim under Florida law. 	See Curry v. Inch, No. 4:18cv207,
2020 WL 1046819, at *1 (N.D. Fla. Mar. 4, 2020) (“Compliance with the
presuit requirements is a condition precedent.”). Rule 9(c) of the Federal
Rules of Civil Procedure provides that a complaint must “allege generally
that all conditions precedent have occurred or been performed.” 	Fed. R.
Civ. P. 9(c).
Thus, in order to comply with Rule 9(c) in a Florida medical
malpractice case brought in federal court, the complaint must “allege
generally” that the plaintiff has satisfied “all conditions precedent.” Fed.
R. Civ. P. 9(c). This does not require the plaintiff to explain in detail how
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the conditions were met, nor is the plaintiff required to submit evidence
at the pleading stage to prove compliance with conditions precedent.
Instead, a general statement of compliance is sufficient. See Curry, 2020
WL 1046819, at *1 (explaining that plaintiff satisfied Rule 9(c) by
generally alleging compliance with conditions precedent and noting that
“[i]t may turn out” the plaintiff “has failed to comply with the Florida
presuit conditions,” but that is “not a decision that can be made” on a
motion to dismiss because the complaint alleged general compliance); see
also Bobbin v. Corizon Health, Inc., No. 2:14cv158, 2014 WL 5474126, at
*6 (M.D. Fla. Oct. 29, 2014) (refusing to dismiss for failure to comply with
Florida’s presuit requirements because the plaintiff satisfied Rule 9(c) by
alleging that she “has complied with all conditions precedent . . . .”).
Here, Plaintiff has failed to “allege generally that all conditions
precedent have occurred or been performed.” 	Fed. R. Civ. P. 9(c). 	His
complaint 	says 	nothing 	about 	compliance 	with 	Florida’s 	presuit
requirements. 	As 	a 	result, 	Plaintiff’s 	medical 	malpractice 	claim
(assuming one has been pled in the complaint) is subject to dismissal for
failure to allege compliance with conditions precedent as required by
Rule 9(c). 	See Fabing v. Gill, No. 8:12cv2579, 2013 WL 704904, at *2
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(M.D. Fla. Feb. 26, 2013) (dismissing medical malpractice claim for
failure to allege satisfaction of conditions precedent as required by Rule
9(c) where the complaint did not allege compliance with Florida’s presuit
requirements).
This conclusion is not inconsistent with the Supreme Court’s recent
decision in Berk v. Choy, 146 S. Ct. 546 (2026). The Berk Court held that
Delaware’s requirement that an affidavit of a physician be attached to a
medical malpractice complaint violated Rule 8 of the Federal Rules of
Civil Procedure. Id. at 554. According to Berk, under Rule 8 “allegations
are sufficient, but under the Delaware law, the plaintiff needs evidence
too” in the form of the attached affidavit. Id. The Court stressed that its
decision was based on Rule 8, and it recognized that Rule 9 was different
because it singled out certain matters “for special treatment[.]” 	Id. at
553.
As discussed above, one of the matters that Rule 9 has singled out
for special treatment are claims that require “conditions precedent.”
With such claims, Rule 9(c) requires that compliance with the conditions
precedent be alleged in the complaint. 	Jackson v. Seaboard Coast Line
R. Co., 678 F.2d 992, 1010 (11th Cir. 1982). 	It is well established that
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Florida’s presuit requirements are conditions precedent. Curry, 2020 WL
1046819, at *1. 	Thus, Rule 9(c)—not Rule 8 as in Berk—applies here.
Moreover, the issue in Berk was whether a complaint could be dismissed
for failing to submit an affidavit as required by Delaware law. 	That is
not the issue here. Rather, the issue is whether Plaintiff’s complaint has
alleged compliance with conditions precedent as required by Rule 9(c). It
has not. Accordingly, Berk is distinguishable and to the extent a medical
malpractice claim has been asserted in the complaint, it should be
dismissed.
III. 	Conclusion
For the reasons above, the Court respectfully RECOMMENDS
that:
(1) Defendant’s motion to dismiss (Doc. 49) be DENIED in part to
the 	extent 	that 	it 	seeks 	dismissal 	of 	Plaintiff’s 	Eighth
Amendment deliberate indifference claim;
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(2) GRANTED in part to the extent that any state law medical
malpractice 	claim 	asserted 	in 	the 	complaint 	be 	dismissed
without prejudice3; and
(3) This matter be recommitted to the undersigned for further
proceedings.
At Pensacola, Florida this 27th day of April 2026.
/s/ 	Zachary C. Bolitho
Zachary C. Bolitho
United States Magistrate Judge
Notice to the Parties
Objections to the proposed findings and recommendations set forth
above must be filed within fourteen days of the date of this Report and
Recommendation. 	Any 	different 	deadline 	that 	may 	appear 	on 	the
electronic docket is for the Court’s internal use only and does not
control. 	An objecting party must serve a copy of the objections on all
other parties. 	A party who fails to object to the magistrate judge’s
findings or recommendations contained in a report and recommendation
waives the right to challenge on appeal the district court’s order based on
unobjected-to factual and legal conclusions. 	See 11th Cir. Rule 3-1; 28
U.S.C. § 636.
3 If Plaintiff wishes to assert a state law medical malpractice claim in
addition to his Eighth Amendment deliberate indifference claim, then he
would need to file an amended complaint that asserts such a claim and
alleges compliance with Florida’s presuit requirements. Absent the filing
of such an amended complaint, this case will go forward on Plaintiff’s
Eighth Amendment deliberate indifference claim.
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