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Berk v. Choy

No. 24-440 SCOTUS · Decided Decided SCOTUS
Cert Granted: Mar 10, 2025 Argued: Oct 6, 2025 Decided: Jan 20, 2026
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Case Overview

Berk v. Choy involves a medical malpractice dispute arising from treatment of a fractured ankle where the physician recommended a conservative course of care. The case raises questions about the standard of care for orthopedic injuries and the evidentiary standard for establishing medical negligence when a physician selects conservative over surgical treatment. It likely tests what expert testimony is required to establish a deviation from the applicable standard of care.

Decision

Opinion Amy Coney Barrett

Opinion of the Court

Amy Coney Barrett

The Facts

Harold Berk fell out of bed while visiting Delaware and was taken by ambulance to Beebe Medical Center, where an X-ray revealed a fractured ankle. Dr. Wilson Choy recommended a protective boot. During fitting, hospital staff forced Berk's leg into the boot, twisting his fractured ankle. Choy did not order another X-ray and sent Berk home. At a follow-up two weeks later, a second X-ray showed the ankle was severely deformed and required surgery. Berk sued Choy and Beebe in federal court for medical malpractice under Delaware law, invoking diversity jurisdiction. He did not provide the affidavit of merit required by Del. Code, Tit. 18, §6853. The District Court dismissed and the Third Circuit affirmed.

The Issue

Whether Delaware's medical malpractice affidavit-of-merit requirement (§6853) applies when a plaintiff brings a state-law malpractice claim in federal court. Berk argued the Federal Rules of Civil Procedure displace the state affidavit law. Choy and Beebe argued the affidavit requirement is a substantive state-law condition that survives in federal court under Erie.

The Rules

Fed. R. Civ. P. 8(a)(2) Notice Pleading Standard

A complaint must contain "a short and plain statement of the claim showing that [the plaintiff] is entitled to relief." By requiring no more than a statement of the claim, Rule 8 establishes "implicitly, but with unmistakable clarity" that evidence of the claim is not required at the pleading stage.

Shady Grove Orthopedic Associates, P.A. v. Allstate Ins. Co., 559 U.S. 393, 398 (2010) Federal Rule Displacement Framework

The Court first asks whether a Federal Rule "answers the question in dispute." If it does, the Federal Rule governs unless it "exceeds statutory authorization or Congress's rulemaking power." Whether the displaced state law is substantive "makes no difference" to the Federal Rule's validity.

28 U.S.C. §1652 (Rules of Decision Act) State Substantive Law in Federal Court

Federal courts apply state substantive law unless the Constitution, a treaty, or a statute otherwise requires or provides. But when a valid Federal Rule of Civil Procedure is on point, it displaces contrary state law even if the state law would qualify as substantive under Erie.

28 U.S.C. §2072(a)-(b) (Rules Enabling Act) Procedural Rules Must Be Procedural

The Supreme Court may prescribe uniform rules of procedure for district courts. Such rules "shall not abridge, enlarge or modify any substantive right." The test is whether the Federal Rule "really regulates procedure" -- if it governs only "the manner and the means" by which rights are enforced, it is valid.

Hanna v. Plumer, 380 U.S. 460, 469-474 (1965) Valid Federal Rules Displace State Law

A valid Federal Rule of Civil Procedure displaces contrary state law even if the state law would qualify as substantive under Erie R. Co. v. Tompkins. When a Federal Rule is on point, the court bypasses Erie's inquiry altogether.

Del. Code, Tit. 18, §6853(a)(1) Delaware Affidavit of Merit Requirement

A medical malpractice complaint "shall not be filed" unless accompanied by an "affidavit of merit" signed by a medical professional attesting to reasonable grounds to believe medical negligence occurred. A plaintiff may secure a single 60-day extension for "good cause."

The Application

Rule 8 Answers the Disputed Question

The Court applied the two-step framework from Shady Grove. First, does a Federal Rule answer the disputed question? The disputed question is whether Berk's lawsuit can be dismissed because his complaint lacked an affidavit. Rule 8 prescribes exactly what a plaintiff must present at the outset of litigation: a short and plain statement of the claim. By requiring no more than a statement, Rule 8 establishes "implicitly, but with unmistakable clarity" that evidence of the claim is not required at the pleading stage.

Rule 12 reinforces this. It provides only one ground for dismissal on the merits: "failure to state a claim upon which relief can be granted." When evaluating that question, courts look only at the complaint's factual allegations and ask whether they "state a claim to relief that is plausible on its face." Delaware's affidavit requirement demands more than Rule 8 allows, and the two rules give different answers to whether Berk's complaint can be dismissed for lacking an affidavit.

Rejecting the Defendants' Workarounds

Defendants offered two counterarguments. First, they cited Cohen v. Beneficial Industrial Loan Corp. (1949) for the proposition that state "preconditions to proceeding" are compatible with the Federal Rules. The Court rejected this reading. Cohen held only that a particular state law addressed a matter unaddressed by the relevant Federal Rule. Here, by contrast, Rule 8 and §6853 address the same issue head-on.

Second, defendants argued that Rule 11's proviso ("unless a rule or statute specifically states otherwise, a pleading need not be verified or accompanied by an affidavit") incorporates state affidavit laws like §6853. The Court rejected this too. Rule 11 governs the conduct of attorneys and pro se parties, not third-party affidavits. The sentence defendants relied on refers to situations where "represented parties are required by rule or statute to verify pleadings or sign affidavits," not to medical expert affidavits from outside the case.

Rules Enabling Act Validity and the Concurrence

At the second step, the Court asked whether Rule 8 is valid under the Rules Enabling Act. The test is modest: does the Federal Rule "really regulate procedure"? Rule 8 determines what plaintiffs must present to the court about their claims at the outset of litigation. It regulates "only the process for enforcing those rights, not the rights themselves, the available remedies, or the rules of decision." Defendants argued the Court should also ask whether the displaced state law is substantive. The Court declined, reaffirming that "the substantive nature of [a state] law, or its substantive purpose, makes no difference" to the Federal Rule's validity. Rule 8 is procedural. It governs. Delaware's affidavit law does not apply in federal court.

Jackson concurred in the judgment but wrote separately. She agreed on the result but located the conflict with Federal Rules 3 and 12 rather than Rule 8, arguing the majority's reading of Rule 8 was too expansive.

The Conclusion

**Delaware's medical malpractice affidavit requirement does not apply in federal court.** Rule 8 answers the disputed question by prescribing that a complaint need only contain a short and plain statement of the claim. Because Rule 8 is valid under the Rules Enabling Act, it displaces the contrary state requirement. The Third Circuit was reversed and the case remanded.

This is a clean application of the Shady Grove framework to medical malpractice screening laws. Multiple states have similar affidavit requirements, and this decision means none of them can be enforced in federal diversity cases. The 8-1 vote, with Barrett writing and only Jackson writing separately, signals strong consensus on the procedural classification of pleading rules.

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Cert GrantedMar 10, 2025
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Decision

Opinion Amy Coney Barrett
SCOTUS TMR-7f9aec84 Jul 5, 2026
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