Shaghayegh Mirshahi, M.d. v. Patient First Richmond Medical Group, LLC; W. Kent Schuele, M.d.; Jennifer Cericola, Rn

UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 25-1720
SHAGHAYEGH MIRSHAHI, M.D.,
Plaintiff – Appellant,
v.
PATIENT FIRST RICHMOND MEDICAL GROUP, LLC; W. KENT SCHUELE,
M.D.; JENNIFER CERICOLA, RN,
Defendants – Appellees.
Appeal from the United States District Court for the Eastern District of Virginia, at
Richmond. M. Hannah Lauck, Chief District Judge. (3:23-cv-00495-MHL)
Submitted: April 6, 2026 Decided: May 27, 2026
Before KING, AGEE, and HEYTENS, Circuit Judges.
Affirmed by unpublished opinion. Judge Heytens wrote the opinion, which Judge King and
Judge Agee joined.
ON BRIEF: Ellen K. Renaud, LAW OFFICES OF ELLEN K. RENAUD, Alexandria,
Virginia, for Appellant. David E. Constine, III, Andrew J. Henson, TROUTMAN PEPPER
LOCKE LLP, Richmond, Virginia, for Appellees.
Unpublished opinions are not binding precedent in this circuit.

-- 1 of 10 --

2
TOBY HEYTENS, Circuit Judge:
Dr. Shaghayegh Mirshahi worked as a physician at one of Patient First Richmond
Medical Group’s clinics. After she was fired, Mirshahi sued Patient First and two of its
employees (her direct supervisor and a nurse), asserting her termination violated Virginia
public policy, state whistleblower protections, and state and federal antidiscrimination
laws. Mirshahi also alleged a state-law defamation claim. The district court ruled for the
defendants on all claims. We affirm.
I.
The district court dismissed three of Mirshahi’s claims under Federal Rule of Civil
Procedure 12(b)(6): unlawful termination in violation of Virginia public policy (Count 1);
retaliatory discharge in violation of the Virginia Whistleblower Protection Act (Count 2);
and defamation per se (Count 5). We review those decisions “de novo, applying the same
standards as the district court.” Pendleton v. Jividen, 96 F.4th 652, 656 (4th Cir. 2024).
Counts 1, 2, and 5 stem from an incident on the morning of July 13, 2021. According
to the complaint—whose factual allegations we accept as true in this posture—Mirshahi
arrived at work feeling sick and “was reasonably concerned she might have COVID-19.”
JA 13. Patient First contacted a replacement, but the defendant nurse told Mirshahi that her
supervisor “said she needed to ‘Get up and go see patients until your replacement comes
in!’” JA 14. Mirshahi “refused to see any patients” that day and eventually went home
“because of sickness.” JA 14–15. “[A]lmost as soon as [Mirshahi] got home,” her direct
supervisor (the other individual defendant) began texting Mirshahi “about her return to
work and whether she could switch shifts to come in.” JA 15. After some texting back and

-- 2 of 10 --

3
forth, Mirshahi called the supervisor “and told him that his words and actions were
inappropriate given her sick condition, and she asked him not to contact her again for the
day.” JA 16. Mirshahi returned to work on July 25 and worked several shifts over the next
four days. On the fourth day, Mirshahi’s supervisor told her that “Patient First had decided
to terminate her contract.” JA 17.
A.
Mirshahi fails to show the district court erred in dismissing her public policy claim
(Count 1). Virginia law “recognize[s] an exception to the doctrine of employment-at-will
based on an employer’s violation of public policy in the discharge of an employee,” which
is commonly known as a Bowman claim. Rowan v. Tractor Supply Co., 559 S.E.2d 709,
710 (Va. 2002); see id. (explaining this exception “stems from” Bowman v. State Bank of
Keysville, 331 S.E.2d 797 (Va. 1985)). Before the district court, Mirshahi argued her
termination violated public policies set out in two statutes: Virginia Code § 54.1-2915(A)
(defining “acts of unprofessional conduct” for Virginia physicians) and Virginia Code
§ 18.2-57 (assault and battery). On appeal, however, Mirshahi asserts Patient First’s
conduct violated a COVID-era emergency regulation for infectious disease prevention
“promulgated by the Virginia Department of Health.” Mirshahi Br. 28.
These belated efforts to shift gears are unavailing. Mirshahi does not argue she can
establish the sort of “exceptional circumstances” necessary to obtain relief on a forfeited
claim. Hicks v. Ferreyra, 965 F.3d 302, 310 (4th Cir. 2020) (quotation marks removed).
Instead, Mirshahi contends she preserved her current argument before the district court
because the “[c]omplaint noted that ‘treating patients while symptomatic . . . would violate

-- 3 of 10 --

4
the COVID-19 guidelines set forth by the Virginia Department of Health (“VDH”) and the
CDC.’” Mirshahi Reply Br. 3 (quoting JA 15). We doubt this single, generalized allegation
was enough to put the district court on notice that Mirshahi asserted that Patient First’s
actions violated the public policy embodied in the specific emergency COVID regulation
she now cites for the first time on appeal.
But even if she could get over that forfeiture hurdle, Count 1 would still fail as a
matter of law because the emergency COVID regulation Mirshahi cites does not contain
the type of “explicit[ ] express[ion]” of public policy that her Bowman claim requires.
Rowan, 559 S.E.2d at 711. No doubt, that regulation—like “virtually every statute”—
“expresses a public policy of some sort.” Id. But as Virginia’s highest court has explained,
not every “termination of an employee” that arguably violates “the policy underlying” a
statute (much less a regulation) “give[s] rise to a common law cause of action for wrongful
discharge.” Id. (quotation marks removed). Instead, the Bowman doctrine is a “narrow
exception” to the Commonwealth’s normal rules and plaintiffs bringing such a claim must
identify a “Virginia statute” expressly “establishing a public policy” they claim was
violated. Lawrence Chrysler Plymouth Corp. v. Brooks, 465 S.E.2d 806, 809 (Va. 1996)
(emphasis added). We thus affirm the district court’s dismissal of Count 1.
B.
We reach the same conclusion about the district court’s dismissal of Mirshahi’s
Whistleblower Protection Act claim (Count 2). Although Mirshahi cited other provisions
of the Act before the district court, her arguments on appeal challenge only the court’s
dismissal of her claim under Virginia Code § 40.1-27.3(A)(1). As relevant here, that

-- 4 of 10 --

5
provision forbids “discharg[ing] . . . an employee” who “in good faith reports a violation
of any federal or state law or regulation to a supervisor or to any governmental body or
law-enforcement official.”
The bulk of Mirshahi’s arguments on appeal are not responsive to the district court’s
reasoning. Mirshahi insists she adequately alleged her supervisor’s orders to see patients
while sick violated state and federal law, but that is not what the district court found
lacking. Instead, the court concluded the complaint failed to adequately allege that
Mirshahi made a “good faith report[]” about any such violation “to a supervisor or to any
government body or law-enforcement official.” Va. Code § 40.1-27.3(A)(1) (emphasis
added).
Mirshahi cites only one paragraph in the complaint—paragraph 71—to challenge
the district court’s rejection of her claim. That paragraph made two allegations: (1) that
Mirshahi “called” her supervisor “and told him that his words and actions were
inappropriate given her sick condition”; and (2) that Mirshahi “e-mailed Patient First’s
corporate headquarters, as well as the physician manager for [another clinic], and informed
them that [her supervisor] and [the nurse] had told her to see patients even after she had
been tested for COVID-19.” JA 16.
We agree with the district court that those allegations were insufficient. As for the
first, there is “[a] sizeable gap . . . between ‘inappropriate’ conduct and conduct that
violates a law or regulation.” JA 70. And—even assuming the other people Mirshahi
emailed were “supervisor[s]” within the meaning of Virginia Code § 40.1-27.3(A)(1)—we
agree that Mirshahi’s second allegation cannot plausibly be read to support the conclusion

-- 5 of 10 --

6
that “she functionally reported a violation of any of the cited laws or regulations.” JA 69;
cf. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (“To survive a motion to dismiss, a
complaint must contain sufficient factual matter, accepted as true, to state a claim to relief
that is plausible on its face.” (quotation marks removed)). We do not hold a plaintiff must
cite “a specific statute [or regulation] when she makes her report.” Mirshahi Br. 34. But to
state a claim under the Act, an employee must plausibly allege she complained about
conduct that violates a “federal or state law or regulation” rather than the employer’s own
policies or general best practices. Va. Code § 40.1-27.3(A)(1). The complaint’s allegations
failed to clear that bar here.
C.
We also affirm the dismissal of Mirshahi’s defamation per se claim (Count 5). On
appeal, Mirshahi relies exclusively on a statement the defendant nurse allegedly made to
unspecified “co-workers” while Mirshahi was “waiting for her COVID-19 test results”:
“She is not sick. She is not sick . . . she’s pretending.” JA 14 (boldface removed).
That statement does not give rise to a defamation per se claim. Under Virginia law,
“defamatory words . . . are actionable per se” if they “prejudice [the plaintiff] in his or her
profession or trade.” Fleming v. Moore, 275 S.E.2d 632, 635 (Va. 1981) (quotation marks
removed). That test is stricter than it might first appear. For the relevant type of “prejudice
to arise, the statements must relate to ‘the skills or character required to carry out the
particular occupation of the plaintiff.’” Swengler v. ITT Corp. Electro-Optical Products
Div., 993 F.2d 1063, 1070–71 (4th Cir. 1993) (emphasis added) (quoting Fleming,
275 S.E.2d at 636). Here again, we agree with the district court: The statement Mirshahi

-- 6 of 10 --

7
relies on neither “relate[s] to the skills or character required to carry out the particular
occupation of physician” nor casts doubt on her abilities as a doctor. JA 79–80 (quotation
marks removed). Compare Virginia Citizens Def. League v. Couric, 910 F.3d 780, 785
(4th Cir. 2018) (rejecting a lawyer’s defamation per se claim against the creators of an
edited interview because that interview “had nothing to do with [the attorney’s] legal
practice or expertise”), with Tronfeld v. Nationwide Mut. Ins. Co., 636 S.E.2d 447, 449–50
(Va. 2006) (Agee, J.) (holding statements that an attorney “just takes people’s money” and
that his “clients . . . would receive more money for their claims if they had not hired [him]”
“prejudice[d] [the attorney] in his profession” (alterations removed)).
II.
The district court granted summary judgment to Patient First on Mirshahi’s two
remaining claims: “color, sex, and national origin” discrimination in violation of both
Title VII of the Civil Rights Act of 1964 (Count 3) and the Virginia Human Rights Act
(Count 4). JA 22–23. The district court applied the same legal standards when analyzing
both the federal and state antidiscrimination claims, and neither party challenges that
approach. Once again, we review the district court’s decision “de novo, applying the same
legal standards as the district court.” Alexander v. Connor, 105 F.4th 174, 177 (4th Cir.
2024) (quotation marks removed). And, once again, we see no reversible error.
Based on the record developed during discovery, the district court concluded that a
single decisionmaker—Patient First’s vice president—made the call to terminate
Mirshahi’s employment after seeing a series of text messages Mirshahi sent her supervisor.
In those messages, Mirshahi announced she would “not be micromanaged” and had

-- 7 of 10 --

8
“decided” to “resume giving [non-Patient-First-approved handouts] to patients” despite
having previously been directed to stop doing so. JA 364. Mirshahi stated she was not
“interested in [corporate’s] theoretical problems” with the handouts and declared: “This is
not a request. I am not asking permission.” Id. In a declaration submitted in support of the
defendants’ motion for summary judgment, the vice president stated that he “decided that
[Mirshahi] needed to be terminated because of the Text and her stated willful disregard for
Patient First, [its] policies, and [her Physician Employment] Agreement.” JA 430.
In contrast, Mirshahi argues Patient First really fired her because she is a “female
of Iranian heritage with a brown complexion.” JA 22. Because Mirshahi offered no “direct
evidence of discrimination,” the district court analyzed her claims under “the
burden-shifting framework set out in McDonnell Douglas Corp. v. Green, 411 U.S. 792
(1973), and its progeny.” Wannamaker-Amos v. Purem Novi, Inc., 126 F.4th 244, 255
(4th Cir. 2025). “To establish a prima facie case of discrimination” under that framework,
Mirshahi needed to show at least one “adverse action” that “occurred under circumstances
that raise a reasonable inference of unlawful discrimination.” Id. (quotation marks
removed). This is not simply a pleading requirement. Rather, to avoid summary judgment,
Mirshahi had to produce “specific facts showing there is a genuine issue for trial.” Celotex
Corp. v. Catrett, 477 U.S. 317, 324 (1986) (quotation marks removed); accord Robinson v.
Priority Auto. Huntersville, Inc., 70 F.4th 776, 785 (4th Cir. 2023) (stating that “neutral
facts, an adverse action, and speculation about discriminatory motives” are insufficient “to
make it past” summary judgment).
We agree with the district court that Mirshahi failed to produce sufficient evidence

-- 8 of 10 --

9
from which a jury could reasonably infer that Patient First fired her for unlawful reasons.
To start, Mirshahi points to two emails—one sent more than three months before
she was fired; the other, three weeks before—in which the vice president referred to
Mirshahi as “Shagi” and described her as “crazy,” respectively. JA 441, 644. Mirshahi
reasonably objects to both statements. But we conclude that neither—at least without other
evidence absent here—suffices to raise an inference of discrimination based on color, sex,
or national origin. Cf. Burlington N. & Santa Fe Ry. Co. v. White, 548 U.S. 53, 68 (2006)
(citing a treatise for the proposition that “snubbing by supervisors and co-workers [is] not
actionable” under Title VII (quotation marks removed)).
Mirshahi also makes an argument based on timing, noting the vice president had
announced an intent to discuss Mirshahi at an upcoming meeting before receiving the text
messages Patient First asserts formed the basis for her termination. But even though we
must draw all reasonable inferences in Mirshahi’s favor, see Anderson v. Liberty Lobby,
Inc., 477 U.S. 242, 255 (1986), we conclude this fact—again, absent other evidence—
raises no inference of unlawful discrimination. For one thing, we agree with the district
court that the record is best read as establishing “that Dr. Mirshahi’s complaints of dealing
with ageism, sexism, and racism” in the workplace—“rather than her color or national
origin itself—were to be discussed at the meeting.” JA 131 (quotation marks removed).
And even assuming a reasonable jury could infer that the vice president already viewed
Mirshahi as a problem employee before seeing the text messages, that alone would not
support a further inference that she was fired based on her color, sex, or national origin (or
any protected characteristic).

-- 9 of 10 --

10
Finally, Mirshahi asserts Patient First did not terminate one of its White
employees—a physician’s assistant—despite a verbal outburst. But proposed comparators
must be “similarly-situated in all respects,” Cosby v. South Carolina Prob., Parole &
Pardon Servs., 93 F.4th 707, 714 (4th Cir. 2024) (emphasis and quotation marks removed),
and here they are not. As Patient First explains, the physician’s assistant “and Mirshahi had
different supervisors, held different positions, and did not engage in the same” alleged
misconduct. Patient First Br. 28. What is more, there is no dispute that it was the vice
president—not Mirshahi’s direct supervisor or that supervisor’s supervisor—who made the
decision to fire her, and Mirshahi points to no evidence calling into question the vice
president’s statement that he knew nothing about the physician’s assistant’s conduct.
In every employment discrimination case, “[t]he ultimate burden of persuading the
trier of fact that the defendant intentionally discriminated against the plaintiff remains at
all times with the plaintiff.” Texas Dep’t of Cmty. Affs. v. Burdine, 450 U.S. 248, 253
(1981). Because Mirshahi did not produce sufficient evidence to demonstrate she could
carry that burden at trial, the district court correctly granted summary judgment against her
on Counts 3 and 4.
* * *
We dispense with oral argument because the facts and legal contentions are
adequately presented in the materials before us and argument would not aid the decisional
process. The judgment is
AFFIRMED.

-- 10 of 10 --