USCA4 Appeal: 23-2026 Doc: 43 Filed: 02/10/2025 Pg: 1 of 16

UNPUBLISHED

UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT

No. 23-2026

WILLARDA V. EDWARDS, M.D.,

Plaintiff – Appellant,

v.

AMERICAN MEDICAL ASSOCIATION, INC.,

Defendant – Appellee.

Appeal from the United States District Court for the District of Maryland, at Baltimore. George L. Russell, III, Chief District Judge. (1:22-cv-03297-GLR)

Submitted: November 21, 2024 Decided: February 10, 2025

Before AGEE, QUATTLEBAUM, and RUSHING, Circuit Judges.

Affirmed by unpublished per curiam opinion.

ON BRIEF: Timothy F. Maloney, Alyse L. Prawde JOSEPH, GREENWALD & LAAKE, P.A., Greenbelt, Maryland, for Appellant. Clifford J. Zatz, Rebecca Baden Chaney, Jillian Ambrose, CROWELL & MORING LLP, Washington, D.C., for Appellee.

Unpublished opinions are not binding precedent in this circuit. USCA4 Appeal: 23-2026 Doc: 43 Filed: 02/10/2025 Pg: 2 of 16

PER CURIAM:

In 2022, Dr. Willarda V. Edwards was a candidate for the American Medical

Association (“AMA”) President-Elect position. Prior to the election, a member of the

AMA’s Board of Trustees allegedly defamed her by informing the AMA’s delegates that

she was accused of campaign violations. As a result, she brought multiple claims against

the AMA, including defamation, false light invasion of privacy, and civil conspiracy. The

district court dismissed her complaint in its entirety under Federal Rule of Civil Procedure

12(b)(6). Upon review, we agree with the district court that Dr. Edwards’ claims fail as a

matter of law.

I.

Dr. Edwards has served in various elected and appointed positions at medical

associations, including the AMA Board of Trustees. 1 Throughout her career, she has also

“been a national leader in addressing racial disparities in American health care.” J.A. 17.

In June 2022, Dr. Edwards, an African-American woman, was the leading candidate

of the AMA Southeastern Delegation (the “SED”) for the national AMA President-Elect

position. She was informed that Dr. William Reha, a candidate for the AMA vice-

speakership from the SED, intended to withdraw his candidacy. Under one viewpoint, Dr.

1 Because the district court dismissed Dr. Edwards’ complaint for failure to state a claim under Rule 12(b)(6), we recount the facts as alleged in the complaint and assume their validity at this stage. Mason v. Mach. Zone, Inc.,

, 317 n.2 (4th Cir. 2017).

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Reha’s withdrawal could increase Dr. Edwards’ opportunity to win the President-Elect

position, so some colleagues suggested that she call Dr. Reha to thank him.

During the phone call, Dr. Reha informed Dr. Edwards that he was “putting [his]

card down,” meaning that, contrary to what she had heard, Dr. Reha did still intend to run

for the vice-speakership position. J.A. 10. Dr. Reha asked Dr. Edwards how his decision

affected her candidacy. Unbeknownst to Dr. Edwards, Dr. Reha allegedly recorded their

phone call, but the contents of that call are otherwise unknown.

The next day, Dr. Edwards arrived at the AMA annual meeting in Illinois. After Dr.

Edwards completed interviews related to her candidacy, AMA Vice-Speaker Dr. Lisa

Egbert asked Dr. Edwards to come with her. Dr. Egbert brought Dr. Edwards to meet with

the AMA Election Campaign Committee (the “Committee”). 2

In that meeting, the Committee accused Dr. Edwards of “vote trading” and

questioned her about the alleged “vote trading activity.” J.A. 12. Later, the Committee

informed the Southeast Region that a “formal complaint” had been filed and that the

Committee had conducted “multiple interviews” about its allegations. J.A. 12. The

Committee did not provide Dr. Edwards with any evidence, information about the

interviews, or a copy of the complaint.

A few days later, Dr. Bruce Scott, the Speaker of the AMA House of Delegates (the

“House”), spoke at the AMA’s Monday Business Session. During that speech, he informed

The complaint references an “Election Committee” and an “Election Campaign 2

Committee.” Based on the complaint, it appears that these are the same entities. Consequently, throughout this opinion, that entity will be referred to as the “Committee.” 3 USCA4 Appeal: 23-2026 Doc: 43 Filed: 02/10/2025 Pg: 4 of 16

the delegates that the Committee had received a complaint against Dr. Edwards alleging a

potential campaign violation. He further stated that Committee members had interviewed

multiple individuals said to have knowledge of the circumstances and “reviewed evidence

that was deemed credible and corroborated that a campaign violation” occurred. J.A. 14.

He explained that, based on the information gathered, the SED and another delegation

arranged a “quid pro quo” where the other delegation “would support Dr. Edwards’ current

candidacy, and [SED] would support a future candidate from the other delegation.” J.A.

14. Finally, he stated that she took “advantage of this arrangement,” and that “the House—

you—are the final arbiter with your votes.” 3 J.A. 14. Dr. Edwards then spoke before the

House and denied any wrongdoing.

After the Monday Business Session, MedPage Today published an article online

about Dr. Scott’s speech, which included his purportedly defamatory statements.

The next day, Dr. Scott repeated the allegations regarding Dr. Edwards’ campaign

violations “to more than 600 delegates just minutes prior to the casting of votes.” J.A. 15.

He also stated that “the findings of the Election Committee still stand,” “rumors that [it]

had reversed its decision were incorrect,” and “Dr. Edwards was guilty of vote trading.”

J.A. 15. Before Dr. Edwards could respond to these allegations, the delegates voted for the

President-Elect position.

Despite Dr. Scott’s defamatory statements, Dr. Edwards advanced to the run-offs in

the election, but ultimately lost the race. The SED requested information from the

3 Dr. Edwards alleged that the AMA’s governing documents do not, in fact, provide that the AMA House of Delegate is the final arbiter of violations of campaign rules. 4 USCA4 Appeal: 23-2026 Doc: 43 Filed: 02/10/2025 Pg: 5 of 16

Committee about the allegations against her. In response, the Committee stated that “the

sanction for the violation was the announcement to the House.” J.A. 16. The SED thereafter

reported to its membership that “the whole affair lacked any reasonable semblance of due

process: neither the charges nor any of the evidence was ever presented for rebuttal as well

as any ability for her, or us, to face the accusers.” J.A. 16.

In retrospect, it became “obvious that the only so-called ‘evidence’ against Dr.

Edwards was Dr. Reha’s surreptitiously recorded telephone call.” J.A. 13. In her view,

“structural racism” caused the Committee to sabotage her campaign, evidenced by the fact

that the AMA “has never treated a candidate who was not a person of color in this fashion.”

J.A. 17.

The district court granted the AMA’s motion to dismiss Dr. Edwards’ complaint for

failure to state claim. It found that the common interest privilege shielded the AMA’s

statements from defamation and false light liability, and that her allegations failed to

overcome that privilege by making the required showing that the statements were made

with actual malice. Thus, based on the absence of an underlying tort, the district court also

dismissed her civil conspiracy claim.

Dr. Edwards timely appealed, J.A. 37, and we have jurisdiction under

.

II.

We review de novo a district court’s grant of a motion to dismiss. Ray v. Roane,

(4th Cir. 2020). To survive a motion to dismiss for failure to state a claim,

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“a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to

relief that is plausible on its face.’” Ashcroft v. Iqbal,

(2009) (quoting

Bell Atl. Corp. v. Twombly,

(2007)). A claim “has facial plausibility

when the plaintiff pleads factual content that allows the court to draw the reasonable

inference that the defendant is liable for the misconduct alleged.”

Notably, “[a] defamation complaint, like any other civil complaint in federal court,”

must meet federal pleading standards. Hatfill v. N.Y. Times Co.,

(4th

Cir. 2005). Thus, “the usual standards of notice pleading apply in defamation cases,”

meaning that although “there is no heightened pleading standard for malice, [it] must still

be alleged in accordance with Rule 8—a ‘plausible’ claim for relief must be articulated,”

Mayfield v. Nat’l Ass’n for Stock Car Auto Racing, Inc.,

(4th Cir. 2012)

(emphasis omitted).

III.

Dr. Edwards first contends that the common interest privilege is inapplicable. But

even if it applies, she argues that her allegations in the complaint are sufficient to show

actual malice that overcomes the privilege. On both counts, we disagree.

We must first address which state’s substantive law to apply. Kerr v. Marshall Univ.

Bd. of Governors,

(4th Cir. 2016) (“Under the familiar Erie doctrine, we

apply state substantive law and federal procedural law when reviewing state-law claims.”).

Before the district court, the parties cited both Maryland and Illinois law in their arguments

regarding dismissal of the claims, but Dr. Edwards also contended that Illinois law applied

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based on choice-of-law principles. Nonetheless, the district court opted to “utilize law from

both jurisdictions,” just as the parties did in their briefs. J.A. 30. And on appeal, Dr.

Edwards failed to raise a choice-of-law argument until her Reply Brief, which is

insufficient to preserve the argument for our review. Grayson O. v. Agadir Int’l LLC,

(4th Cir. 2017). Thus, we will take the same approach as the district court

and evaluate Dr. Edwards’ claims under Maryland and Illinois law.

Ultimately, the issue of which state’s law applies is inconsequential because, under

either state’s law, her claim fails. Both states recognize that certain qualified privileges

“shield a person’s statements from liability for defamation.” Lindenmuth v. McCreer,

(Md. Ct. Spec. App. 2017); see Dent v. Constellation NewEnergy, Inc.,

(Ill. 2022). And as relevant here, they both acknowledge a “common

interest privilege” where the publisher shares an interest with the individuals to whom the

defamatory matter is published. 4 See Gohari v. Darvish,

(Md. 2001)

(finding a qualified privilege “among members of identifiable groups [who] share similar

goals or values,” such as “interests in . . . professional dealings”) (cleaned up); Dent,

(explaining that a qualified privilege arises where an “interest of the person

to whom the matter is published or of some other third person is involved”) (quoting Kuwik

v. Starmark Star Mktg. & Admin., Inc.,

(Ill. 1993)). That privilege

4 Illinois does not refer to this privilege as the “common interest privilege” in its case law. Nonetheless, it recognizes a privilege where parties share a common interest, and thus for clarity, we use the same term throughout this opinion. See Dent¸

.

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extends not only to defamation claims, but also to claims of false light invasion of privacy.

Lindenmuth,

.

Under both Maryland and Illinois law, the defendant bears the initial burden of

establishing that an allegedly defamatory statement was privileged, which is a question of

law. Gohari,

; Kuwik, 619 N.E.2d at 133–34. Upon a showing that a

statement was privileged, the burden shifts and “the plaintiff must produce facts,

admissible in evidence, demonstrating the defendant abused the privilege,” i.e., “that the

defendant made his or her statements with malice.” Piscatelli v. Van Smith,

(Md. 2012); see Kuwik,

.

Although ultimately a distinction without a difference for our purposes, it is worth

noting that Maryland and Illinois diverge slightly in their definitions of malice. In

Maryland, malice is “a person’s actual knowledge that his [or her] statement is false,

coupled with his [or her] intent to deceive another by means of that statement,” Piscatelli,

(alterations in original), which is not satisfied by a reckless disregard for

the truth, Seley-Radtke v. Hosmane,

(Md. 2016) (explaining that the

standard for malice adopted in Piscatelli does not encompass a reckless disregard for the

truth). Illinois, by contrast, employs a broader definition, defining malice as not only a

person’s actual knowledge of falsity, but also their “reckless disregard of [the defamed

party’s] rights and of the consequences that may result to him.” Kuwik,

(alteration in original). So while actual knowledge of falsity constitutes malice in both

states, a lower standard—reckless disregard for the truth—is also sufficient to overcome a

qualified privilege in Illinois.

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With these principles in mind, we turn now to consider the initial question of

whether the AMA established a common interest qualified privilege under Maryland and

Illinois law. We find that it has.

Dr. Edwards alleged that Dr. Scott, a member of the Committee, shared the

defamatory statements with delegates prior to the election. And under Maryland law, Dr.

Scott and the AMA’s delegates had a common interest as members of an “identifiable

group[]” that shared an interest in “professional dealings.” Gohari,

.

Similarly, under Illinois law, the election was an occasion “where a misstatement of

information should be afforded some degree of protection in order to facilitate the free flow

of correct information,” meaning that Dr. Scott’s statements are entitled to a qualified

privilege. Stavros v. Marrese,

, 1018–19 (Ill. App. 2001) (applying a

qualified privilege because officials “have an interest in knowing whether [] employees are

performing their official duties in a professional manner”). At bottom, the defamatory

statements concerned “one of the candidates for presidency of the national organization

allegedly engag[ing] in improper vote trading through an alleged quid pro quo.” J.A. 33.

The AMA’s delegates plainly have an interest in that information. Therefore, the privilege

applies under both states’ laws.

Dr. Edwards resists this conclusion, contending that media presence during Dr.

Scott’s statements constituted excessive publication and foreclosed application of the

privilege. But as the AMA points out, she waived this argument by failing to raise it before

the district court. See In re Under Seal,

(4th Cir. 2014) (“If a party

wishes to preserve an argument for appeal, the party must press and not merely intimate

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the argument during the proceedings before the district court.” (cleaned up)). And even if

it was not waived, the argument fails. Her lone allegation regarding the media’s presence

states: “MedPage Today published online detailed reporting about Dr. Scott’s conduct. . .

. That article included the false and defamatory statements that [he] [] made to the House.”

J.A. 14. However, she fails to allege that Dr. Scott actually made the allegedly defamatory

statements to the media, as nothing in the complaint suggests that members of the media

were actually present for his statements, or if they were, that he knew of that presence. See

Restatement of Torts (First) § 604 (Am. L. Inst. 1938) (explaining that excessive

publication occurs when an individual “knowingly publishes [defamatory] matter to a

person to whom its publication is not otherwise privileged”). And viewing her allegations

through the lens of Iqbal,

, it is not reasonable to infer from the complaint

as pleaded that the media was present, particularly in light of Dr. Edwards’ allegations that

Dr. Scott made the statements to “the delegates,” J.A. 14–15.

Because the common interest privilege applies, the next inquiry is whether Dr.

Edwards’ allegations of malice overcome that privilege. As an initial matter, Dr. Edwards

contends that the district court erred in dismissing her claims at this stage because whether

the AMA acted with actual malice is a question for the fact-finder. But as discussed above,

“the usual standards of notice pleading apply in defamation cases,” and so a plaintiff must

articulate “a ‘plausible’ claim for relief” in accordance with Federal Rule of Civil

Procedure 8. Mayfield,

. And both Maryland and Illinois have recognized

that, under their respective pleading standards, the issue of whether a plaintiff has alleged

actual malice sufficient to overcome a qualified privilege can be decided as matter of law.

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See Piscatelli,

(“While malice is usually a question for the fact-finder, it

need not be submitted to the fact-finder when the plaintiff fails to allege or prove facts that

would support a finding of malice.”); Dent, 202 N.E.3d at 258–59 (reversing the finding

that allegations were sufficient to withstand a motion to dismiss where “there [was] no set

of [the alleged] facts which would show an abuse of the qualified privilege,” i.e., actual

malice). Accordingly, we ask whether Dr. Edwards has alleged facts that, if accepted as

true, plausibly show actual malice under Maryland or Illinois law.

Upon review of Dr. Edwards’ allegations of malice—i.e., an actual knowledge of

falsity or a reckless disregard for the truth—we find that they do not overcome the

privilege. On this point, Mayfield is instructive. There, we found that the Appellants did

not plausibly allege actual malice where they alleged that statements regarding Mayfield’s

positive drug tests “were known by [Appellees] to be false at the time they were made,

were malicious or were made with reckless disregard as to their veracity.” 674 F.3d at 377–

78. We held that “[t]his kind of conclusory allegation—a mere recitation of the legal

standard—is precisely the sort of allegations that Twombly and Iqbal rejected.” Id. at 378.

Nor were we persuaded that the remaining allegations stated a claim; namely, that

“Appellees intended to harm Mayfield by publishing his drug test results,” that they “failed

to follow [] testing procedures,” and “that [they] were informed by Mayfield that he took

both Claritin and Adderall.” Id. Instead, we noted that Appellants admitted that Appellees

“contacted Mayfield to follow up on the issue, ask[ed] him what drugs he had taken as part

of their investigation,” and “was randomly selected to undergo drug testing pursuant to a

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valid NASCAR policy and two separate tests yielded a positive result for

methamphetamine,” which cut against a finding of malice. Id. (emphases omitted).

Our reasoning in Mayfield maps precisely onto the facts here. In conclusory fashion,

Dr. Edwards alleges that the “AMA made the statements with actual malice,” it “acted

with, and was motivated by, the knowledge that these statements were false and with the

intent to cause harm to Dr. Edwards,” and it “reckless[ly] disregard[ed] [] the truth or falsity

of these statements.” 5 J.A. 19. But “a mere recitation of the legal standard” is insufficient

to satisfy our pleading standard. Mayfield,

. To support her conclusion, she

alleges that the evidence referenced by Dr. Scott and reviewed by the Committee “was not

credible, . . . there was no ‘quid pro quo’ that had been arranged, . . . and [she] did not act

to take advantage of any such alleged arrangement.” J.A. 18. But even accepting that the

evidence was not credible, she fails to allege that Dr. Scott himself had any reason to

believe—let alone actually know—that it was not credible at the time of his statements.

Consequently, her allegations do not reasonably permit the inference that the statements

were made with actual malice under Maryland law, i.e., that they were “the product of [Dr.

Scott’s] imagination” or “so inherently improbable that only a reckless person would have

put [them] in circulation.” Cap.-Gazette Newspapers, Inc. v. Stack,

, 1044

5 To be clear, we addressed a different issue in Mayfield: whether the plaintiff, as a public figure, adequately alleged actual malice as defined in New York Times v. Sullivan,

(1993).

. Yet, regardless of whether the definitions of malice are the same, Mayfield is instructive in evaluating, as a federal procedural matter, whether Dr. Edwards has adequately pleaded actual malice sufficient to overcome a qualified privilege. And the answer to that question is, of course, informed by the state substantive law underlying Edwards’ defamation claim. See Kerr,

.

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(Md. 1982). They similarly fail under Illinois’ lower standard of recklessness, as they do

not suggest that he published his statements with “a high degree of awareness of its

probable falsity or that [he] had serious doubts as to its truth.” Coghlan v. Beck,

(Ill. 2013). Thus, since Dr. Edwards has not alleged facts that, if accepted as true,

show actual malice under Illinois or Mayland law, she has failed to plausibly plead a claim.

In the alternative, Dr. Edwards contends that her allegations regarding the

inadequacy of the AMA’s investigation are evidence of actual malice. Again, we find her

argument does not carry the day. She alleges that the Committee is a “star chamber” with

“no semblance of transparency, due process, or basic fairness,” and that she “had no

opportunity to rebut the ‘evidence’ against her.” J.A. 12–13. But actual malice in both

states cannot be established “merely by showing . . . [that] the publisher acted without

undertaking the investigation that would have been made by a reasonably prudent person.”

Cap.-Gazette Newspapers, Inc.,

; cf. Dent,

. And even

taking Dr. Edwards’ allegations as true, Dr. Scott stated that the Committee conducted

multiple interviews, gathered credible evidence, and corroborated that a violation occurred.

Cf. Dent,

(finding that Dent failed to allege actual malice to overcome

a qualified privilege where he “did not allege any facts showing that respondents failed to

investigate the truth of the matter, for example, by interviewing other guests”). She does

not allege that the Committee did not, in fact, take those actions. Instead, she simply alleges

that the evidence was not credible. But that is not the same as plausibly alleging that the

Committee altogether failed to conduct a reasonable investigation. Thus, as a matter of law,

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Dr. Edwards has failed to carry her burden of overcoming the AMA’s qualified privilege

based on actual malice.

Based on that conclusion, we can also dispense with Dr. Edwards’ false light

invasion of privacy claim. False light claims must meet the same legal standards as

defamation claims, including that a statement is made with actual malice. Our finding that

the AMA did not defame Dr. Edwards therefore “render[s] superfluous a separate analysis

of [her] false light claim.” Piscatelli,

; see Kolegas v. Heftel Broad. Corp.,

, 209–10 (Ill. 1992) (requiring that, to prove a false light claim, a plaintiff

must allege “that the defendants acted with actual malice, that is, with knowledge that the

statements were false or with reckless disregard for whether [they] were true or false”). 6

Accordingly, we affirm the district court’s dismissal of Dr. Edwards’ defamation

and false light claims.

IV.

Dr. Edwards next contends that, because the district court erred in dismissing her

defamation and false light claims, it necessarily erred in dismissing her civil conspiracy

claim based on her failure to allege an underlying tort. Again, we disagree.

6 In the alternative, the AMA contends that Dr. Edwards is a limited-purpose public figure and thus must meet the standard of actual malice articulated in Sullivan. Because the district court did not reach this issue and we find that Dr. Edwards’ claims fail under Maryland and Illinois law, we decline the AMA’s invitation to address this issue in the first instance on appeal.

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Civil conspiracy is the “combination of two or more persons by an agreement or

understanding to accomplish an unlawful act or to use unlawful means to accomplish an

act not in itself illegal, with the further requirement that the act or the means employed

must result in damages to the plaintiff.” Marshall v. James B. Nutter & Co.,

(4th Cir. 2014) (quoting Hoffman v. Stamper,

(Md. 2005)); see

McClure v. Owens Corning Fiberglass Corp.,

(Ill. 1999) (defining

civil conspiracy as “a combination of two or more persons [by an agreement] for the

purpose of accomplishing by concerted action either an unlawful purpose or a lawful

purpose by unlawful means”). Neither Maryland nor Illinois recognizes a standalone civil

conspiracy claim; such a claim requires an underlying tort be committed in furtherance of

the agreement. Marshall,

; McClure,

.

As discussed above, we affirm the district court’s dismissal of Dr. Edwards’

defamation and false light claims. Consequently, she has failed to allege an underlying tort

that was committed in furtherance of the civil conspiracy. The absence of such a tort is

fatal to her civil conspiracy claim. See Tri-Plex Tech. Servs., Ltd. v. Jon-Don, LLC,

, 465–66 (Ill. 2024) (affirming dismissal of a civil conspiracy claim because

“the plaintiff [] failed to state an independent cause of action”); Alleco Inc. v. Harry &

Jeanette Weinberg Found., Inc.,

(Md. 1995) (same). We thus affirm

the district court’s dismissal of Dr. Edwards’ civil conspiracy claim.

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V.

For the reasons discussed, we affirm the district court’s dismissal of Dr. Edwards’

defamation, false light invasion of privacy, and civil conspiracy claims.

AFFIRMED

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