Pacio v. Franklin Hosp., 63 A.D.3d 1130 (2d Dep't 2009) involved a plaintiff who had fallen at home and was hospitalized; he acquired bedsores during the first hospitalization, was transferred to nursing home, and was later transferred to a second hospital for shortness of breath and bedsores. The lower court found that plaintiff's allegation that the second hospital failed to follow its own protocol in caring for plaintiff's pressure ulcers sounded in medical malpractice, not negligence, and that expert testimony was required, because the "'conduct complained of . . . constitutes an integral part of the process of rendering medical treatment to the plaintiff."' Id. at 1132. The Second Department affirmed the lower court, reasserting the principle that "a claim sounds in medical malpractice 'when the challenged conduct constitutes medical treatment or bears a substantial relationship to the rendition of medical treatment by a licensed physician.' In contrast, a claim sounds in negligence 'when the gravamen of the complaint is not negligence in furnishing medical treatment to a patient, but the hospital's failure in fulfilling a different duty.'" Id.