U.S. COURT OF APPEALS FOR THE THIRD CIRCUIT No. 24-2673 JONATHAN DIF RAIA v. Kevin Ransom , Superintendent

U.S. COURT OF APPEALS FOR THE T HIRD CIRCUIT
No. 24-2673
JONATHAN D IF RAIA,
Appellant
v.
K EVIN R ANSOM , S UPERINTENDENT ; JASEN B OHINSKI ,
D EPUTY S UPERINTENDENT FOR C ENTRALIZED S ERVICES; D R .
T IMOTHY K ROSS ; W AYNE I NNISS , C ORRECTIONS
C LASSIFICATION P ROGRAM M ANAGER ; R AWLINGS, D RUG
AND A LCOHOL T REATMENT S PECIALIST , et al.
______________________________
On Appeal from the U.S. District Court, M.D. Pa.
Judge Jennifer P. Wilson, No. 1:23-cv-01187
Before: B IBAS, P ORTER , and B OVE, Circuit Judges
Argued Jan. 27, 2026; Filed Mar. 31, 2026
_____________________________
O PINION OF THE C OURT
B IBAS, Circuit Judge. Cruel and unusual punishment, like
intentional discrimination, requires not only a wrongful act but
also a blameworthy mind. So prisoners may not use either the
Eighth Amendment or the Americans with Disabilities Act to
challenge prison officials’ good-faith judgments about medical
treatment. Yet that is just what prisoner Jonathan DiFraia tries

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to do. As a drug addict, he got medication as part of his prison’s
drug-treatment program. But after officials accused him of
diverting his medication to other prisoners, they kicked him
out of the program. Nothing in the record suggests that they
meant to (or were even reckless about) exposing DiFraia to
more harm, or that they disciplined him because of his drug
addiction. So the District Court properly dismissed both federal
claims. In dismissing DiFraia’s state-law negligence claim,
though, it relied on circuit precedent that has since been abro-
gated. We will thus AFFIRM the dismissal of DiFraia’s two fed-
eral claims, VACATE the dismissal of the negligence claim, and
REMAND.
I. S USPECTED OF D IVERTING M EDICATION,
D IF RAIA IS P HASED OUT OF D RUG T REATMENT
DiFraia is a Pennsylvania state prisoner. As an opioid addict,
he was approved for medication to help control his drug crav-
ings. Medications like methadone and buprenorphine allay an
addict’s cravings without creating a high, reducing the risk of
relapse. DiFraia was prescribed and got Suboxone, a brand of
buprenorphine. The prison made Suboxone available as part of
a Medication Assisted Treatment program, which offered pris-
oners “long-term care strategies of medication management
and continued monitoring” to help control their addictions. Pa.
Dep’t of Corr., Medication Assisted Treatment (MAT)
[https://perma.cc/Y9FF-NZ2J] (last accessed Mar. 3, 2026);
see also App. 4 n.2.
These medications are themselves opioids, so prisons with
treatment programs typically do not let prisoners consume
them alone. Rather, prisons administer them in medication

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lines or the like. One day, while in the medication line, DiFraia
was strip-searched and found to have contraband: an e-cigarette
with a cap on it. Guards accused him of using the cap to divert
(smuggle) the medication to other prisoners and wrote him up
for contraband, though DiFraia denied the charge.
A week later, DiFraia was once again in the medication line.
That time, after consuming his dose of Suboxone, he was again
written up for having contraband and diverting his medication. He
denied the allegation once more. Three days later, he met with Dr.
Timothy Kross. Dr. Kross told him that he was being “removed
from” the program for diversion. App. 31.
Rather than force DiFraia to go off Suboxone cold turkey—
which would have triggered withdrawal—Dr. Kross gradually
tapered DiFraia’s doses over the next week. Even so, DiFraia
soon suffered withdrawal symptoms, causing him to “pick[ ]
[at his] arms,” leaving scars. Id. at 32. His mental health also
suffered. He wrote to the superintendent and other prison offi-
cials asking to be put back on Suboxone, but they refused.
DiFraia was told that he “did not have to actually be caught
diverting to be considered a diverter,” limiting his access to
Suboxone. Id. at 31.
In response, DiFraia sued Dr. Kross, the superintendent,
and various other prison officials. His pro se complaint alleges
violations of the Eighth Amendment, the Americans with Dis-
abilities Act, and the “Tort Acts.” App. 32. We review de novo,
construing his pro se complaint liberally. Haines v. Kerner,
404 U.S. 519, 520–21 (1972) (per curiam); Vorchheimer v.
Phila. Owners Ass’n, 903 F.3d 100, 105 (3d Cir. 2018).

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II. D IF RAIA FAILS TO S TATE
AN E IGHTH A MENDMENT C LAIM
DiFraia charges the doctor and prison officials with violat-
ing the Eighth Amendment by being “deliberat[ely] indif-
feren[t] to [his] medical needs.” App. 32. Read liberally, his
pro se complaint seeks relief under 42 U.S.C. § 1983. Yet it
fails to state a claim.
A. Historically, the Eighth Amendment banned
intentional sentences, not prison conditions
The Eighth Amendment bars “cruel and unusual punish-
ments.” At the Founding, “the word ‘punishment’ referred to
the penalty imposed for the commission of a crime.” Helling v.
McKinney, 509 U.S. 25, 38 (1993) (Thomas, J., dissenting)
(citing five dictionaries from the Founding era through the
early nineteenth century). The term “cruel” meant “horrid
modes” of abuse, such as “the rack or the stake.” Baze v. Rees,
553 U.S. 35, 98 (Thomas, J., concurring in the judgment)
(quoting James A. Bayard, A Brief Exposition of the Constitu-
tion of the United States 154 (2d ed. 1840)). And the amend-
ment used “unusual” in the sense of “contrary to [long] usage”
or without “precedent.” Harmelin v. Michigan, 501 U.S. 957,
974 (1991) (opinion of Scalia, J.); see also John F. Stinneford,
The Original Meaning of “Unusual”: The Eighth Amendment
as a Bar to Cruel Innovation, 102 Nw. U. L. Rev. 1739, 1767,
1810–15 (2008).
So the Eighth Amendment was about choices at sentencing.
It cabined the power of judges and juries to intentionally inflict
horribly painful sentences that were outside “the bounds of
[the] common-law tradition.” Id. (both sources); see also

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Louisiana ex rel. Francis v. Resweber, 329 U.S. 459, 463
(1947) (Reed, J., plurality opinion). Examples included
“[b]reaking on the wheel, flaying alive, rending asunder with
horses, … maiming, mutilating and scourging to death.” Ben-
jamin L. Oliver, The Rights of an American Citizen 186 (1832).
And the amendment prevented decisionmakers from sub-
stituting cruelty when ordinary punishments were unavaila-
ble. For instance, shortly before the English Bill of Rights, the
King’s Bench sentenced perjurer and Protestant cleric Titus
Oates to be defrocked, pilloried, whipped, and imprisoned for
life because it could not sentence him to death. See Harmelin,
501 U.S. at 969–73 (opinion of Scalia, J.). In response to those
sorts of grotesque excesses, Parliament (and later, the Framers
of the Constitution) checked judges’ and juries’ retributive
impulses. Helling, 509 U.S. at 38, 40 (Thomas, J., dissenting).
But the Eighth Amendment did not “encompass a prisoner’s
injuries that b[ore] no relation to his sentence,” such as those
from “prison deprivations.” Id. It was addressed to judges and
juries, not jailers. And it sought to curb intentional cruelty, not
neglected prisons.
B. The Eighth Amendment’s history still shapes its
modern limits
Half a century ago, the Supreme Court expanded the Eighth
Amendment beyond its original bailiwick. In Estelle v. Gam-
ble, the Court reasoned that a prison’s failure to give prisoners
needed medical treatment could lead to “physical torture or a
lingering death,” akin to the barbaric, outdated punishments
targeted by the Eighth Amendment. 429 U.S. 97, 103 (1976)
(internal quotation marks omitted). So the Court held that the

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government’s deliberate failure to provide medical care is tan-
tamount to cruel and unusual punishment when it “wanton[ly]
inflict[s] … unnecessary pain.” Id. at 105. The Court later
extended Estelle to prison conditions more broadly. See
Rhodes v. Chapman, 452 U.S. 337, 347 (1981).
Estelle was a doctrinal innovation. It stretched what
counted as punishment past suffering that was both authorized
by a sentence and grounded in a judge or jury’s subjective intent
to inflict pain. Even so, Estelle retained the Eighth Amend-
ment’s historic tie to subjective blameworthiness in an important
respect. Prison conditions do not violate the Eighth Amend-
ment unless officials have “acted with deliberate indifference
to the inmates’ health or safety.” Hope v. Pelzer, 536 U.S. 730,
738 (2002) (internal quotation marks omitted, emphasis
added). All too often, courts focus just on the noun “indiffer-
ence” at the expense of the adjective “deliberate.” See gener-
ally Brawner v. Scott County, 18 F.4th 551, 555–56 (6th Cir.
2021) (Readler, J., dissenting from denial of rehearing en
banc). But the adjective remains a crucial link between the
Eighth Amendment’s original meaning and how we continue
to apply it.
The adjective keeps the Eighth Amendment’s mental stand-
ard subjective, not objective. But cf. Palakovic v. Wetzel, 854
F.3d 209, 223–24 (3d Cir. 2017) (applying objective mental
standard to prisoner risk of suicide). Negligence, even gross
negligence, is not enough. See Farmer v. Brennan, 511 U.S.
825, 835–37 & n.4 (1994). A prison official must be at least
subjectively reckless. That means he “must consciously disre-
gard a substantial risk of serious harm” to the prisoner. Id. at
839 (cleaned up) (quoting the Model Penal Code’s definition

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of recklessness). He must both be aware of the relevant facts
and actually “draw the inference” that the prisoner faces such
a risk. Id. at 837. If the official is not even conscious of the
facts or the risk, his neglect cannot amount to punishment.
Estelle’s noun—indifference—further limits what kind of
behavior violates the Eighth Amendment. Indifference requires
more than just making the wrong judgment call or failing to
prevent harm. And in the specific context of prison medical
care, it is not enough that a prisoner or another doctor would
prefer a different approach than the one corrections officials
took. “[M]ere disagreements over medical judgment do not
state Eighth Amendment claims.” White v. Napoleon, 897 F.2d
103, 110 (3d Cir. 1990). “There may, for example, be several
acceptable ways to treat an illness.” Id. “For better or worse,
prisoners aren’t constitutionally entitled to their preferred treat-
ment plan or to medical care that is great, or even very good.”
Keohane v. Fla. Dep’t of Corr. Sec’y, 952 F.3d 1257, 1277
(11th Cir. 2020) (cleaned up). And sometimes keeping an eye
on a problem without doing more is a reasonable choice.
In short, even as expanded by the Court, the Eighth Amend-
ment does not create a general constitutional tort of prison neg-
ligence. It requires subjective blameworthiness as well as seri-
ous mistreatment or neglect.
C. DiFraia fails to plead serious neglect or mistreatment
Against that backdrop, we consider DiFraia’s claim. To
plead that deficient medical care violated the Eighth Amend-
ment, a prisoner must make both “an objective showing that
[his medical] needs were serious” and “a subjective showing
that the defendants were deliberately indifferent to [those]

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medical needs.” Pearson v. Prison Health Serv., 850 F.3d 526,
534 (3d Cir. 2017) (cleaned up). We assume without deciding
that, as an opioid addict, DiFraia had medical needs that were
objectively serious. Cf. Foelker v. Outagamie County, 394 F.3d
510, 511–13 (7th Cir. 2005) (concluding that a prisoner suffer-
ing from opioid withdrawals that caused him to hallucinate and
defecate on the floor of his cell had objectively serious medical
needs). But DiFraia does not come close to alleging deliberate
indifference to those needs.
1. Deliberate indifference requires serious neglect or mis-
treatment. Deliberate indifference is a stringent standard. Typ-
ically, we have let medical-care claims proceed only when care
was all but absent. For example, a jail with hundreds of inmates
could be liable for having no psychiatric professionals on staff.
Inmates of Allegheny Cnty. Jail v. Pierce, 612 F.2d 754, 761–
63 (3d Cir. 1979). A prison could likewise be liable for refusing
to let a sick prisoner get any medical help. See Monmouth Cnty.
Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326, 346–47 (3d Cir.
1987).
Yet when a plaintiff alleges not “a complete denial of med-
ical care” but “inadequate medical treatment,” we have required
him to plead more. Pearson, 850 F.3d at 535 (internal quota-
tion marks omitted). For claims of inadequate medical care, we
presume the treatment proper and require allegations “that it
violates professional standards of care” in some extreme way.
Id. That means more than “[m]ere medical malpractice.”
White, 897 F.2d at 108. For instance, one prison doctor could
be sued for repeatedly withholding medications for epilepsy,
an ear infection, hypertension, and severe boils, all of which
other doctors had prescribed, despite having reason to believe

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the prior prescriptions were the only realistic response. Id. at
110−11. In another case, we reinstated an Eighth Amendment
claim because a prison lacked enough psychiatric staff, “kept
poor medical records,” ignored requests for counseling, refused
to provide treatments apart from medication, did not check
whether medications were effective, did not ensure frequent
mental-health appointments, and did not train staff on how to
respond to mentally ill prisoners. Palakovic, 854 F.3d at 216,
228.
DiFraia, though, argues for much broader liability. He says
prisons may never deny medical care unless they base their denial
on “individualized medical judgment.” Appellant’s Br. 15. For
support, he relies on our court’s statement that “delay[ing] nec-
essary medical treatment based on a non-medical reason” can
count as deliberate indifference. Id. at 37 (quoting Rouse v.
Plantier, 182 F.3d 192, 197 (3d Cir. 1999) (Alito, J.)). But he
ignores a key word in that statement: necessary. An official
risks violating the Eighth Amendment if he invokes non-
medical reasons to delay or deny care that is medically neces-
sary. It is not enough that a treatment might make a prisoner’s
life easier.
Our precedents, as well as persuasive authority from our
sister circuits, drive that point home. Courts have found Eighth
Amendment violations, for example, when officials “intended
to inflict pain on prisoners without any medical justification.”
White, 897 F.2d at 109 (responding to prisoner’s complaint that
he could not feel his hands by burning them with a lit book of
matches). Relatedly, prison guards may not retaliate against a
prisoner by denying essential medical care. See Durham v.

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Kelley, 82 F.4th 217, 230 (3d Cir. 2023) (refusal to treat pris-
oner’s severe back pain because prison staff disliked his “pen-
chant for complaining” and “descri[bed] him as an
‘a**hole’ ”); Hartsfield v. Colburn, 371 F.3d 454, 456–57 (8th
Cir. 2004) (delay of critical dental care because prisoner was
“threatening and argumentative”); Archer v. Dutcher, 733 F.2d
14, 17 (2d Cir. 1984) (letting Eighth Amendment claim go to
jury when prison officials refused to take pregnant, bleeding
prisoner to hospital because she was “obstreperous and a dis-
ciplinary problem”).
Courts have also found Eighth Amendment violations when
officials denied care based solely on its cost, without making
any effort to minimize harm. In one case, there was evidence
that a doctor delayed a stroke victim’s therapy for more than
four months because of its cost. Durmer v. O’Carroll, 991 F.2d
64, 68 & n.10 (3d Cir. 1993). In another circuit, a prison refused
to provide eye surgery because it had decided that “one eye is
good enough for prison inmates.” Colwell v. Bannister, 763
F.3d 1060, 1063 (9th Cir. 2014); see also id. at 1084 (Bybee,
J., dissenting) (flagging cost constraints on providing cataract
surgery). Still another refused to treat hepatitis C in prisoners
nearing the end of their sentences, when the doctor admitted
“there may not have been any real medical reason” for the pol-
icy “other than to keep it simple for folks.” Roe v. Elyea, 631
F.3d 843, 863 & n.17 (7th Cir. 2011). So far from banning all
non-medical considerations, courts forbid only retaliation, delib-
erately inflicting pain or harm, and refusing to treat at all based
solely on cost.
2. DiFraia’s allegations do not plausibly add up to delib-
erate indifference. Those standards are not met here.

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According to the complaint, at first prison staff treated
DiFraia’s opioid addiction with Suboxone. Then “Dr. Kross …
told [DiFraia that he] was being removed from [Medically As-
sisted Treatment] Suboxone for diversion.” App. 31. But the
doctor did not force him to go cold turkey. Instead, he gave
DiFraia a “[t]aper[ed] [dose] of 7 days,” which would wean
him off the medication and possibly alleviate his eventual with-
drawal symptoms. Id. So DiFraia had some treatment for his
opioid addiction. And even after the tapered doses ended,
DiFraia never alleges that he sought or was refused other forms
of medical care.
Those facts distinguish this case from the ones discussed
above. This case is not about retaliation, intentional infliction
of harm, or a refusal to spend. Instead, DiFraia simply dis-
agrees with Dr. Kross’s decision to take him off Suboxone. He
never alleges that Dr. Kross (or anyone else) concluded that
Suboxone was necessary to manage his addiction. In fact, addic-
tion can be treated in many ways, including medically super-
vised cold-turkey detoxification or medications to control crav-
ings. Absent allegations that prison officials strayed well beyond
the range of reasonable options, the judiciary may not second-
guess “mere disagreements over medical judgment.” White,
897 F.2d at 110. Indeed, we have “specifically held that there
is no constitutional right to methadone” for a prisoner addicted
to heroin. United States ex rel. Walker v. Fayette County, 599
F.2d 573, 575 (3d Cir. 1979) (per curiam). That holding spikes
DiFraia’s suggestion that each prisoner has a right to particular
addiction treatments absent an individualized medical judg-
ment precluding an alternative course of treatment.

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3. Any suggestion that the diversion finding was pretextual
is implausible. One sentence in DiFraia’s complaint comes
closer to stating a constitutional violation: the allegation that
he was “removed from medication for disciplinary sanctions.”
App. 32. By that, DiFraia might mean that even if he was divert-
ing Suboxone, cutting off his supply was retaliatory and thus
deliberately indifferent. That argument is a nonstarter, since
DiFraia never alleged that officials had judged that Suboxone
was medically necessary to treating his addiction. And even if
he had, diverting medication suggests that one no longer needs
it; prison officials cannot be deliberately indifferent to a medi-
cal need that no longer exists.
More likely, however, DiFraia is trying to allege that he was
not in fact diverting Suboxone, so the finding was a pretext.
App. 31 (alleging that the e-cigarette “was not altered or being
utilized for nefarious means”). In theory, DiFraia could sug-
gest that prison officials falsely accused him of diversion to trig-
ger excruciating withdrawals to punish him for some other,
undisclosed transgression. If true, that could indeed amount to
deliberate indifference under our precedents.
Yet nothing in the complaint supports an inference that the
diversion finding was a pretext for punishing DiFraia. He alleges
no history of mistreatment or run-ins with the guards who
manned the medication line. Nor does he allege that Dr. Kross
or the guards harbored any ill will. Indeed, the idea that Dr.
Kross wanted to hurt him is belied by the doctor’s decision to
taper DiFraia’s dose over seven days, rather than cut him off
cold turkey. So the suggestion of pretext is implausible, and we
need not assume that it is true. See Ashcroft v. Iqbal, 556 U.S.
662, 680–81 (2009). From the allegations in the complaint, the

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only plausible conclusion is that, after finding the e-cigarette
on DiFraia, the guards genuinely believed that DiFraia was
diverting his Suboxone. And Dr. Kross genuinely believed that
DiFraia no longer needed it to manage his addiction but could
be weaned and treated in other ways. Perhaps they were right;
perhaps mistaken. But the Eighth Amendment does not ban
mistakes, let alone judgment calls. That limit dooms DiFraia’s
deliberate-indifference claim.
III. D IF RAIA FAILS TO A LLEGE C AUSATION AS
R EQUIRED BY THE ADA
DiFraia also claims that the Americans with Disabilities
Act bars taking even a medication diverter off Suboxone. The
relevant provision of Title II bars a public entity from discrim-
inating against or excluding a “qualified” disabled person from
its programs or services “by reason of such disability.” 42
U.S.C. § 12132. We construe DiFraia’s pro se complaint liber-
ally as referring to this section and as naming the defendants in
their official capacities. Contra App. 11–13 (reading the com-
plaint as limited to the defendants’ individual capacities). Cf.
Montanez v. Price, 154 F.4th 127, 145 (3d Cir. 2025) (constru-
ing Title II as not allowing suits against prison officials and
doctors in their individual capacities). The Act abrogates state
sovereign immunity and so authorizes suits for money dam-
ages in some situations. Durham, 82 F.4th at 228. But we need
not decide whether this is such a situation, because DiFraia’s
claim fails for another reason: causation.
We assume that DiFraia is a qualified person, that his opi-
oid addiction is a disability, and that he was excluded from the
prison’s Medically Assisted Treatment program. But he must

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also show that his disability was a but-for cause of his being
kicked out of that program. CG v. Pa. Dep’t of Educ., 734 F.3d
229, 235–36 (3d Cir. 2013). And this is where DiFraia stum-
bles—he cannot show causation. He was kicked out of the
treatment program not “by reason of” his addiction, but despite
it. 42 U.S.C. § 12132. The program exists to treat addicts, not
exclude them. DiFraia’s allegations offer no hint that he was
kicked out of a program designed to treat prisoners with a spe-
cific condition because he has the very condition that warrants
being in the program.
A hypothetical may illustrate the point. Imagine two iden-
tical alcoholics in the same rehab program: Adam and Bert.
While in rehab, Adam is accused of assaulting Charlie and gets
kicked out. Bert, who is not accused of assaulting anyone, stays
in the program with Charlie, David, Eddie, and all the other
recovering alcoholics. Though Adam’s addiction explains why
he was in rehab in the first place, it has nothing to do with why
he was kicked out of it; the sole cause of that was his alleged
assault. (That is true whether he actually assaulted Charlie or
was falsely accused, as DiFraia claims he was.) So too here.
Resisting this conclusion, DiFraia relies on one of our
cases, Furgess v. Pennsylvania Department of Corrections,
933 F.3d 285, 291 (3d Cir. 2019). In Furgess, a disabled pris-
oner misbehaved and was put into disciplinary confinement,
where none of the showers were handicapped-accessible. The
prison said that there was no causation, claiming that the pris-
oner had lost the ability to shower only because he had misbe-
haved, not because he was disabled. Id. We rejected that claim,
reasoning that “[a] prisoner’s misconduct does not strip him of
his right to reasonable accommodations.” Id.

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Furgess, though, is distinguishable. In that case, the pris-
oner faced worse conditions than other prisoners in discipli-
nary confinement—he was locked up with no usable shower,
while they were locked up with showers that they could use.
His disability, not his misbehavior, is what prevented him from
showering. Here, though, the cause is not disability but diver-
sion. Consider what would happen to a non-addicted prisoner
caught diverting some other controlled medication: Nothing in
the complaint suggests that such a prisoner would not also have
that medication cut off, facing the same discipline. Both the
addict and non-addict wrongdoers would experience the same
result, and it has nothing to do with disability. By contrast, in
Furgess, the results for the disabled and non-disabled wrong-
doers differed, and did so because of disability.
DiFraia also cites district-court cases about prisons that
denied all Suboxone-like medications to opioid-addicted pris-
oners. See, e.g., Smith v. Aroostook County, 376 F. Supp. 3d
146, 159 (D. Me. 2019) (finding that such a policy treated
opioid-addicted prisoners differently and that refusing to offer
exceptions to the policy was a failure to provide a reasonable
accommodation). But district-court cases do not bind us. And
in any event, this prison did give medication to addicted pris-
oners, just not to those accused of diverting their medication.
Nor did the prison deny DiFraia a reasonable accommoda-
tion by refusing to reinstate his Suboxone. As DiFraia sees it,
providing Suboxone to an opioid-addicted prisoner is a “rea-
sonable accommodation to allow meaningful access to carceral
healthcare.” Appellant’s Br. 26; see 42 U.S.C. § 12131(2)
(referring to “reasonable modifications to rules, policies, or
practices”); Berardelli v. Allied Servs. Inst. of Rehab. Med.,

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900 F.3d 104, 116 (3d Cir. 2018) (noting that Title II’s use of
the term “reasonable modifications” tracks other provisions of
the Act referring to “reasonable accommodations”). But that
claim conflates a method of treating a disability with an accom-
modation: DiFraia never alleged that he could not receive any
prison healthcare for his addiction because he was not getting
Suboxone. So DiFraia’s reasonable-accommodations argu-
ment just repackages his complaint that he was not given the
treatment he desired. But “failure to provide adequate medical
care to a disabled inmate does not, on its own, give rise to lia-
bility under the ADA.” Montanez, 154 F.4th at 147.
In sum, the prison officials denied DiFraia Suboxone despite
his alleged disability, not “by reason of” it. That denial does
not violate the Act.
IV. D IF RAIA’S N EGLIGENCE C LAIM M AY P ROCEED
Last, DiFraia alleges a claim under the “Tort Acts,” claim-
ing that “the Doctor and Prison officials were negligent.” App.
32. After noting that the Federal Tort Claims Act does not apply
to state prisons, the District Court read this as a state-law neg-
ligence claim and dismissed it because he failed to include a
signed doctor’s certificate as required by Pennsylvania law.
See Pa. R. Civ. P. 1042.3.
Under Pennsylvania law, medical-malpractice plaintiffs
must file a “certificate of merit” within sixty days of suing. A
doctor must certify that there is a “reasonable probability” that
the medical treatment complained of “fell outside acceptable
professional standards” and “was a cause in bringing about the
harm.” Id. 1042.3(a)(1). The Federal Rules impose no such
requirement.

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Our precedent applied Pennsylvania’s rule to state-law
medical-malpractice claims brought in federal court. Liggon-
Redding v. Est. of Sugarman, 659 F.3d 258, 264–65 (3d Cir.
2011). But the Supreme Court just abrogated that precedent,
holding that Delaware’s analogous requirement did not apply
in federal court. Berk v. Choy, 607 U.S. ___, 146 S. Ct. 546,
557 (2026). Because the District Court dismissed the state-law
negligence claim under Liggon-Redding without otherwise
passing on it, we will vacate and remand to let it address that
claim’s merits in the first instance.
* * * * *
Prisoners do not get all the medical care that they want.
Even if they suffer because prison officials deny them care, that
alone is not enough to violate the Eighth Amendment or the
Americans with Disabilities Act. We will thus AFFIRM the dis-
missal of those two federal claims, VACATE the dismissal of the
state-law negligence claim, and REMAND.
Counsel for Appellant
Joseph Longley [Argued]
Jennifer Wedekind
A MERICAN C IVIL L IBERTIES U NION
Sarah B. Bellos
Matthew A. Feldman
P ENNSYLVANIA INSTITUTIONAL L AW P ROJECT
Counsel for Commonwealth Appellees
Kathleen A. Wilde LaBay [Argued]
P ENNSYLVANIA A TTORNEY G ENERAL ’S O FFICE
Counsel for Dr. Kross

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Samuel H. Foreman
Benjamin M. Lombard [Argued]
W EBER G ALLAGHER S IMPSON S TAPLETON F IRES &
N EWBY
Counsel for Amicus Curiae Addiction Medicine Specialists
James P. Davy
A LL R ISE TRIAL & A PPELLATE
Counsel for Amicus Curiae Former Corrections Officials
Russell H. Falconer
G IBSON D UNN & C RUTCHER LLP

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