No. 21-1571

AMERICAN BOARD OF INTERNAL MEDICINE,

Plaintiff, Appellee,

v.

JAIME A. SALAS RUSHFORD, MD,

Defendant/Third Party Plaintiff, Appellant, CHRISTINE K. CASSEL; NAOMI P. O'GRADY; PEARSON EDUCATION, INC.; JOAN M. VON FELDT; LYNN LANGDON; RICHARD DOE; DAVID L. COLEMAN; RICHARD BARON; ERIC S. HOLMBOE; COMPANIES A,B,C; DOCTORS 1-2800; JOHN DOE; RICHARD DOE,

Third Party Defendants, Appellees.

APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO

[Hon. Silvia Carreño-Coll, U.S. District Judge]

Before

Barron, Chief Judge, Lipez and Thompson, Circuit Judges.

Andrew L. Schlafly for appellant.

Paul Lantieri, III, with whom Carlos A. Rodriguez-Vidal, Goldman Antonetti & Cordova LLC, Hara K. Jacobs, and Ballard Spahr LLP were on brief, for appellees. August 29, 2024 LIPEZ, Circuit Judge. The American Board of Internal Medicine ("ABIM") suspended the certification of appellant Dr. Jaime Salas Rushford, a Puerto Rico physician, after concluding that he improperly gave board exam questions to his test prep instructor. ABIM then sued Salas Rushford for copyright infringement in federal court in New Jersey. This appeal addresses only Salas Rushford's counterclaims against ABIM and ABIM-affiliated individuals (the "ABIM Individuals") alleging a "sham" process leading to his suspension. The counterclaims were transferred to Puerto Rico, where the district court granted appellees' motion for judgment on the pleadings. The court also denied Salas Rushford leave to amend his pleading. We affirm.

I.

We review an entry of judgment on the pleadings de novo, "view[ing] the facts contained in the pleadings in the light most favorable to the nonmovant and draw[ing] all reasonable inferences in his favor." Zipperer v. Raytheon Co., 493 F.3d 50, 53 (1st Cir. 2007). We may, however, "augment these facts and inferences with data points gleaned from documents incorporated by reference into the complaint." Haley v. City of Bos., 657 F.3d 39, 46 (1st Cir. 2011). Here, accordingly, we recite the facts as alleged by Salas Rushford and assume their veracity, gleaning factual content

- 3 - from documents Salas Rushford referenced in his complaint that ABIM subsequently provided in its motion.1 A. Factual Background

1. Salas Rushford's Board Certification

Salas Rushford is a physician specializing in internal medicine who is licensed to practice in Puerto Rico as well as several states. After completing his residency, Salas Rushford sought certification in internal medicine from ABIM. ABIM is a private nonprofit offering certification in internal medicine and numerous subspecialties. While board certification is not legally required to practice medicine, it is a highly valuable credential, as it is necessary to obtain admission privileges at most hospitals and is a requirement for employment in many medical practices. According to ABIM, it grants board certification in internal medicine to physicians who meet certain requirements, including completion of an accredited three-year residency and passing the board exam, which is a ten-hour computer-based exam administered at testing centers around the United States.2

Salas Rushford was scheduled to take the board exam on August 20, 2009, at a testing center in Puerto Rico. According to

1 When helpful to provide context, we also refer to ABIM's original complaint, though we do not assume the truth of its allegations. 2 ABIM refers to the physicians it has certified as "diplo