No. 22-2442 ___________________________

Shafik Wassef, M.D.

lllllllllllllllllllllPlaintiff - Appellant

v.

Dennis Tibben, in his Official Capacity; Brenna Bird, in her Official Capacity1

lllllllllllllllllllllDefendants - Appellees ____________

Appeal from United States District Court for the Southern District of Iowa - Central ____________

Submitted: January 11, 2023 Filed: May 22, 2023 ____________ Before SMITH, Chief Judge, WOLLMAN and LOKEN, Circuit Judges. ____________ LOKEN, Circuit Judge.

In this § 1983 lawsuit, Dr. Shafik Wassef seeks declaratory and injunctive relief to stop ongoing physician disciplinary proceedings in which the Iowa Board of

1 We substitute Executive Director Dennis Tibben of the Iowa Board of Medicine for Jill Stuecker, the former Interim Executive Director, and Iowa Attorney General Brenna Bird for Thomas J. Miller, the former Attorney General. See Fed. R. App. P. 43(b). Medicine (“the Board”), represented by the Attorney General of Iowa, charges Wassef with violating Iowa law by inappropriately accessing patient records during his residency at the University of Iowa Hospitals and Clinics (“UIHC”). The Board is responsible for regulating the practice of medicine in Iowa and is authorized to discipline doctors who do not meet minimum practice standards established by the Board and by the Iowa Legislature. See Iowa Code §§ 147.2, 147.13(1), 147.36, 148.7, 272C.4-.6; Iowa Admin. Code r. 653-23.1 et seq. and 653.24 et seq.

Wassef alleges the ongoing proceedings violate federal law -- the Health Insurance Portability and Accountability Act (“HIPAA”), Pub. L. No. 104-191, 110 Stat. 1936 (1996), which regulates disclosure of identifiable health information, and his right to procedural due process. The district court2 dismissed the action, concluding that it must abstain pursuant to Younger v. Harris, 401 U.S. 37 (1971). The court also dismissed the due process claim because Wassef failed to exhaust state remedies and failed to plausibly allege a claim. We conclude the district court properly abstained under Younger. However, as the state disciplinary proceedings are ongoing, the court should have declined to reach the merits of the due process claim, which Wassef can litigate in the state proceedings. Accordingly, we modify the dismissal to be without prejudice, which is usually the proper disposition when a court abstains under Younger. See Bloodman v. Wood, 510 F. App’x 490, 491 (8th Cir. 2013).

I. Background

The following facts are taken from the allegations in Wassef’s Amended Complaint, which we assume to be true. From July 2014 to June 2018, Dr. Wassef trained as a resident physician in radiology at UIHC. In October 2018, the Board

2 The Honorable Rebecca Goodgame Ebinger, United States District Judge for the Southern District of Iowa.

-2- notified Wassef “it was investigating a complaint [from UIHC] regarding his alleged unauthorized access to medical records while he was a resident physician” at UIHC. In February 2021, the Board filed a “Statement of Charges” accusing Wassef of violating Iowa Code § 148.6(2)(i) and Iowa Administrative Code rule 653-23.1(10).

The Statement of Charges initiated a formal contested case proceeding under the Iowa Administrative Code. The Attorney General’s Office assumed responsibility to prosecute the Board’s case against Wassef. Iowa law provides opportunities to pursue discovery, to have an evidentiary hearing before a neutral Adminis