## Facts

- Michelle McCall received prenatal care and delivered her child at a U.S. Air Force medical facility in Florida.
- She suffered post-delivery complications and died from excessive blood loss.
- Her estate and survivors sued the United States for medical negligence and wrongful death under the Federal Tort Claims Act.
- After a bench trial, the federal district court found the United States negligent and that the negligence proximately caused McCall’s death.
- The district court awarded approximately $980,462 in economic damages and $2 million in noneconomic wrongful-death damages allocated among McCall’s parents and infant son.
- Applying Fla. Stat. § 766.118(2), the district court reduced total noneconomic damages to $1 million based on a per-incident cap for wrongful-death medical malpractice claims.
- On appeal, the Eleventh Circuit certified questions to the Florida Supreme Court regarding whether the cap violated the Florida Constitution and how the cap operated (per-claimant or per-incident).

## Issues

1. Whether Fla. Stat. § 766.118’s per-incident cap on wrongful-death noneconomic damages in medical malpractice actions violates the Florida Constitution’s Equal Protection Clause (Art. I, § 2).
2. If the cap is constitutional, whether it applies per claimant or per incident in a wrongful-death action with multiple survivors.
3. Whether the cap violates Florida constitutional guarantees of access to courts and the right to jury trial.

## Decision

- The Florida Supreme Court held that the statutory cap on wrongful-death noneconomic damages in Fla. Stat. § 766.118(2) violates the Florida Constitution’s Equal Protection Clause.
- The Court applied rational-basis review and concluded the cap arbitrarily reduced recoveries for cases with the most severe harm and multiple survivors.
- The Court determined the cap lacked a rational relationship to the asserted legislative objective of addressing a medical malpractice insurance “crisis.”
- Having found an equal protection violation, the Court declined to answer the remaining certified questions.
- Following the ruling, the Eleventh Circuit reversed the federal judgment to the extent it applied the cap and remanded for entry of judgment consistent with the uncapped noneconomic damages award.

## Legal Principles

- Under Florida equal protection, a statute subject to rational-basis review must bear a rational relationship to a legitimate state objective.
- A damages limitation that imposes materially different burdens on similarly situated claimants, based solely on the number of survivors in a wrongful-death case, may fail rational-basis review.
- A legislative justification premised on an asserted insurance “crisis” must have a reasonable factual basis; where the justification is unsupported by current data, the statute may lack a rational relationship to its stated purpose.
- A per-incident aggregate cap that forces multiple survivors to share a single maximum noneconomic recovery can operate arbitrarily by penalizing families with greater losses and more claimants.

## Conclusion

Florida’s per-incident cap on wrongful-death noneconomic damages in medical malpractice actions was held unconstitutional under state equal protection because it arbitrarily and disproportionately reduced recoveries for the most severely affected families without a rational connection to the asserted policy goal.


Estate of McCall v. United States, 134 So. 3d 894 (Fla. 2014)