FI L ED U.S. COURT OF APPEAL S EL EVENTHCI RCUI T MAY 27, 2011 J OHN L EY CL ERK [PUBLISH]
IN THE UN ITED STATES COURT OF APPEALS FOR THE ELE VENTH CIRCUIT

__ __ __ __ __ __ __ __ __ __ __ __ No. 0 9- 16 37 5

__ __ __ __ __ __ __ __ __ __ __ __ D. C. Dock etNo. 0 7- 00 50 8- CV-MC R/ EMT ESTATE O F MIC HELLE EVETT E MCCALL, By an d Th ro ug h C o- Pers on al Rep res en ta ti ve s Edwar d M . McCa ll II, Mar ga rit a F. McC al l an d J as on W al le y , EDWARD M. MC CALL, MARGARI TA F. MCCALL, JASON WALL EY,
Pl ai nt iff s- App el la nt s,
ve rs us
UNITED STAT ES OF AMERIC A, Defen da nt -Ap pe ll ee.

__ __ __ __ __ __ __ __ __ __ __ __ App eal fro m

th e Uni te d S ta te s Di st ric t Co urt fo r th e North ernDis tri ctof F lo rid a

__ __ __ __ __ __ __ __ __ __ __ __ _ (Ma y 27 , 20 11 )Befo re EDMONDSON, an d M ARTIN, Cir cu itJu dg es , andHODGES, Dis tri ct * Ju dg e. MARTIN, Ci rcu itJu dg e: The cen tra l que st io n p res en te d i n thi s ap pe al is whethe r Fl or id a’s cap on
no ne co no m ic m ed ic al m al pr act ic e d am ag es , Fla . Sta t. § 76 6.1 18 , vi ol at es th e Fl or id a o r Uni te d S ta te s C on st itut io ns . The Es ta te of M ic he ll e Mc Cal l, Ms
. McC al l’s p aren ts , andth e fat he r of Ms . McCa ll ’s so n (c ol le ct iv el y “ Pl ai nt iff

s” ) al so ap pe al th e Dis tri ctCo urt’s ap pl ic at io n o f th atst atut ory cap . After t ho ro ug h
rev ie w andha vi ng ha d t he be ne fitof o ral arg um en t, we co nc lu de th atth e Dis tri ct Co urt d idno t err in ap pl y in g t he cap . W e al so co nc lu de th atFlo rid a’s st atut ory cap pa ss es m

us te r un de r th e Equ al Pro te ct io n C laus e o f th e Fo urte en th Am en dm en t an d t he Taki ng s C laus e o f th e Fi fth Am en dm en t o f th e Uni te d S ta te s Co ns ti tu ti on as we ll as t he Taki ng s C laus e o f Arti cl e X, § 6 (a) o f th e Fl or id a Co ns ti tu ti on . Becau se no Flo rid a Supr em e Co urt d eci si on s p ro vi de co ntro ll in g gu id an ce t o re so lv e Pl ai nt iff s’ othe r ch al le ng es to th is cap on no ne co no m ic
m ed ic al m al pr act ic e d am ag es un de r th atst at e’s Co ns ti tu ti on , we grant , inpa rt, Pl ai nt iff s’ m ot io n t o c ert ify qu es ti on s t o t he Flo rid a Supr em e Co urt.

Honora ble Will iam Terr ell Hodg es, United States District Judge f or the Middle District * of F lorida, sitting by

designation. 2I.

Dur in g J un e 2 00 5, M ic he ll e Mc Cal l re cei ve d p ren at al m ed ic al care at a Uni te d S ta te s Ai r Fo rce c li ni c as anAir Fo rce d ep en de nt . Ms. M cCa ll op te d fo r th e AirFo rce’s fa m il y

pra ct ic e d ep art m en t t o p ro vi de pri m ary pr en at al care an d de li ve ry servi ces th ro ug ho uthe r pr eg nanc y . She ha d ahe al th y an d n orm al pr eg na nc y

un ti l the las t trimeste r. On Fe brua ry 21 , 20 06 , tes t re su lt s re ve al edth at Ms . McCa ll ’s bl oo d p res su re was hi gh an d t ha t s he was s uf feri ng fro m

sev ere pr eecl am ps ia . Ms. M cCa ll ’s ser io us co nd it io n re qu ire d t ha t l ab orbe in du ced imm ed ia te ly. In st eadof tran sf

erri ng Ms . McCa ll to th e OB/ GYN dep artm en t, the fam il y pr act ic e d ep artm en t co nt in ue d t o p ro vi de m ed ic al care . The Ai r Fo rce h os pi ta l
was tem po rari ly una va il ab le forob st etric an d d el iv ery se rv ic es , so m em be rs of t he fam il y pra ct ic e d ep artm en t tran sf erre d M s. M cCa ll to th e Fo rt Walt on Beac h Med ic al Cen te r in st ead . There , Air Fo rce f am il y pra ct ic e d oc to rs tre at edMs
. McC al l fo r hypert en si on an d i nduc edlab or . Whe n M s. M cCa ll di la te d t o fi ve
cen ti m et ers , herco nt ract io ns sl owe d a ndbe cam e weak er. The Air Fo rce f am il y pr act ic e d oc to rs tre at in g M s. M cCa ll cal le d a n Ai r Fo rce o bs te tri ci an , Dr. Arch ib al d, an d a sk edif h e co ul d p erfo rm a ces area n s ect io n. Dr. Arch ib al d rep orte d t ha t h e was pe rfo rm in g a no th er s ur ge ry an d wo ul d n otbe av ai labl e to 3pe rfo rm

a ces area n s ect io n o n M s. M cCa ll un ti l af te r he fin is he d t ha t s ur ge ry . The Air Fo rce f

am il y pra ct ic e d oc to rs pre pa redMs . McCa ll fora ces arean s ect io n b ut di d n otcal l o th er o bs te tri ci an s t o d et erm in e if on e was av ai labl e to pro vi de imm ed ia te m ed ic al care . On Fe brua ry

22 , 20 06 , Dr. Archi ba ldfin al ly arriv edto pe rfo rm th e ces area n
se ct io n, b utMs . McCa ll ’s con tra ct io ns ha d re su m edan d t he Air Fo rce f am il y pr act ic e d oc to rs de ci de d t o a ll ow M s. M cCa ll to de li ve r va gi na ll y . Dr. Arch ib al d le ft t he Fo rt Walt on Med ic al Cen te r. On Fe brua ry 23 , 20 06 at 1 :2 5 a .m ., Ms. McC al l d el iv ereda he al th y baby bo y . Fam il y

m em be rs who vi si te d M s. M cCa ll aft er the de li ve ry

ex pr es se d c on cern s ab ou t the am ou ntof b lo odMs . McCa ll ha d lo stdu rin g d el iv ery. Med ic al pe rs on ne l as su redth es e fam il y m em be rs th atMs
. McC al l was st ab le
. Thi rty-fiv e m in ut es lat er, wh enth e p la cen taha d n otde li ve redas e xp ect ed , two fam il y

pra ct ic e d oc to rs fro m

th e fam il y

pra ct ic e d ep art m en t trie d wi th ou t
su cces s t o m anua ll y

ex tra ctth e p la cen ta . An Ai r Fo rce n ur se an es th et is t adm in is te redad di ti on al ep idur al pa in rel ie f an d g av e Ms . McCa ll two sep arat e do se s o f Mo rp hi ne in tra ve no us ly. Arou nd2: 35 a.m ., th e fam il y pra ct ic e de pa rtment d oc to rs cal le d Dr. Arc hi ba ld , th e o bs te tri ci an , forass is ta nc e whe n t he y
co ul d n otrem ov e th e p la cen tam anua ll y . 4Ms . McCa ll ’s bl oo d p res su re b eg anto dro p rapi dl y an d re m ai ne d da ng ero us ly low o ve r th e n ex t two an d aha lf h ou rs . The Ai r Fo rce n ur se
an es th et is t m on it or in g M s. M cCa ll ’s vi ta l s ig ns di d n otno ti fy th e fam il y

pra ct ic e do ct or s o f th e dro p i n M s. M cCa ll ’s bl oo d p res su re. Dr. Arch ib al d a rri ve d a t 2 :4 5
a.m . andrem ov edth e p la cen tawithi n fi ve m in ut es . The fam il y pra ct ic e de pa rtment d oc to rs in fo rm edDr. Arch ib al d t ha t M s. M cCa ll ha d n otlo stm uc h bl oo d dur in g d el iv ery. Dr. Archi ba ld , ho wev er, n ot ic edsev ere v ag in al lac erat io ns
an d wo rk edto rep ai r th em ov er the ne xtho ur . Duri ng th atti m e, th e AirFo rce
nu rs e an es th et is t m on it or edMs . McCa ll ’s vi ta l s ig ns , rep orte d t o Dr. Arc hi ba ld th atth ey were s tabl e, an d fa il edto in fo rm hi m th atMs . McCa ll ’s bl oo d p res su re
was dang ero us ly low an d c on ti nu in g t o dro p. Dr. Arch ib al d n ev er ch eck edth e vi ta l s ig ns hi m se lf andrel ie d e xc lu si ve ly on t he nurs e to in fo rm hi m of a ny blo od pr es su re ch an ge s o r pr ob le m s. At 3 :5 0 a .m . when Dr. Arch ib al d fi ni sh edhi s wo rk , he r eque st edan imm ed ia te bl oo d c ou ntan d, i f ne ed ed , a tra ns fu si onto co m pe ns at e fo r th e b lo od Ms . McCa ll lo stdu rin g t he pro cedur e. Fo rty min ut es lat er, the fam il y pra ct ic e de pa rtment p hysic ia n o rd eredth e b lo odco un t t es t. Fo rty min ut es aft er tha t, an d
ov er an ho ur

aft er Dr. Arch ib al d h adreque st edimm ed ia te bl oo d wo rk , a nu rs e at te m pt edto dra w bl oo d fr om

Ms . McCa ll . Ms. M cCa ll was u nr es po ns iv e. Sh e

5ha d g on e in to sh oc k a ndcard ia c arr es t as a res ul t o f se ve re b lo odlo ss . It i s n ot

cl ear h ow l on g M s. M cCa ll ha d b een inth is st at e, si nc e n o o ne ha d m on it or edhe r
orch eck edhe r st atus forth e h ou r fo ll owi ng Dr. Arch ib al d’s p ro cedur e. Ms
. McC al l n ev er re ga in edco ns ci ou sn es s an d was rem ov edfro m li fe s up po rt o n Feb ru ary 27 , 20 06
. II. Pl ai nt iff s s ue d t he Uni te d S ta te s u nd er the Fed eral TortCla im s Act (“ FTCA”), 2 8 U.S.C. § § 1 34 6( b) , 26 71 –8 0. Aft er a two- da y be nc h t ria l, the Dis tri ctCo urt fo un d t he Uni te d S ta te s l iabl e und er the FTCA be cau se th e
ne gl ig en ce o f it s emplo y ees pro xi m at el y cau se d M s. M cCa ll ’s dea th
. The Dis tri ct Co urt fo un d t ha t Pl ai nt iff s’ eco no m ic da m ag es , or fi na nc ia l l os se s, am ou nt edto $9 80 ,46 2.4 0. Th e co urt fo un d t ha t Pl ai nt iff s’ no ne co no m ic da m ag es , or
no nf in an ci al lo ss es , to ta le d $ 2 m il li on , in cl ud in g $ 50 0,0 00 forMs . McCa ll ’s so n
an d $ 75 0,0 00 foreachof h er p aren ts . The Dis tri ctCo urt ap pl ie d F lo rid a’s st atut ory cap on no ne co no m ic da m ag es fo r m ed ic al m al pr act ic e cl ai m s an d l im it edPla in ti ffs ’ reco ve ry of n on eco no m ic da m ag es to $1 m il li on . See Fl a. St at . § 7 66 .11 8( 2) . The Di st ric t Co urt re jecte d Pl ai nt iff s’ arg um en t tha t the y

were en ti tl edto th e fu ll $2 m il li on inno ne co no m ic da m ag es be cau se th ey

co ul d re co ve r un de r bo th th e $ 1 m il li oncap for

6“pr act it on ers ” an d t he $1 .5 m il li on cap for“ no np ract it io ne rs .” The Co urt al so

de ni edPla in ti ffs ’ m ot io n c ha ll en gi ng th e co ns ti tu ti on al it y of F lo rid a’s st atut ory cap un de r bo th th e Fl or id a an d Un it edSta te s C on st itut io ns . Pl ai nt iff s n ex t fi le d am ot io n t o a lt er o r am en d t he jud gm en t. Pl ai nt iff s
ren ewedth ei r arg um en t tha t the y were en ti tl edto reco ve r up to $2 .5 m il li on un de r Fl or id a’s st atut ory

cap . The y

arg ue d t ha t the Dis tri ctCo urt s ho ul d h av e h el d t he Egl in Air Fo rce B as e Hos pi ta l v ic ari ou sl y li ab le , as a“ no np ract it io ne r,” fo r th e
ne gl ig en ce o f it s p ract it io ne r em pl oyees. The Dis tri ctCo urt d en ie d P la in ti ffs ’
m ot io n a fte r fi nd in g t ha t i f th e Uni te d S ta te s was vi cari ou sl y li ab le for th e
ne gl ig en ce o f it s emplo y ees , any dam ag es reco ve rab le fro m itwou ldbe subjec t t o Fl or id a’s $1 mil li oncap for“pr act it io ne rs .” Thu s, the co urt d et erm in edth at Pl ai nt iff s’ reco ve rab le no ne co no m ic da m ag es rem ai ne d c ap pe d a t $ 1 m il li on . On ap pe al , Pla in ti ffs ch al le ng e th e Dis tri ctCo urt’s ru li ng s o n b ot h t he ap pl ic at io n a ndco ns ti tu ti on al it y of F lo rid a’s cap on no ne co no m ic da m ag es for
m ed ic al m al pr act ic e cl ai m s. Pl ai nt iff s ar gu e th atFlo rid a’s st atut ory cap vi ol at es th e Equ al Pro te ct io n C laus e o f Fo urte en th Am en dm en t an d c on st itut es a ta ki ng in vi ol at io n o f th e Fi fth Am en dm en t o f th e Uni te d S ta te s C on st itut io n. Pl ai nt iff s al so arg ue th atth e cap vi ol at es th e fo ll owi ng pro vi si on s o f th e Fl or id a Co ns ti tu ti on : (1 ) th e g ua ran te e o f se parat io n o f po wers inArti cl e II, § 3 an d Art ic le V, § 1 ; (2 ) th e 7rig htto tri al by j ury un de r Arti cl e I, § 22 ; (3 ) th e ri gh t o f acc es s t o t he co urts un de r Arti cl e I, § 21 ; (4 ) th e ri gh t t o e qu al pro te ct io n u nd er Art ic le I, § 2 ; an d (5 ) th e pr oh ib it io n a ga in sta ta ki ng of p ro pe rty with ou t ju stco m pe ns at io n u nd er Art ic le X, § 6
. W e ad dr es s ea chof t he se is su es inturn , rev ie win g t he di st ric t co urt’s
co nc lu si on s o f la w de n ov o a ndth e d is tri ctco urt’s fa ctua l fi nd in gs forcle ar erro r. See P ro ud fo otCo ns ul ti ng Co . v. Go rd on , 57 6 F .3d12 23 , 12 30 (11 th Cir . 20 09 ). III. W e fi rs t ad dr es s wh ethe r th e Dis tri ctCo urt p ro pe rly app li edFlo rid a’s cap
on no ne co no m ic da m ag es . For ape rs on al in jury or wro ng fu l d eath c la im ari si ng fro m th e m ed ic al ne gl ig en ce o f “pr act it io ne rs ,” Fl or id a’s st atut e p ro vi de s: (a) [R]egard le ss of t h e n u m be r of su ch pr act it io ne r de fen da nt s, no ne co no mic da m ag es sh al l no t ex ceed $5 00 ,00 0 pe r cl ai m an t. No pr act it io ne r sh al l be l iabl e fo r m or e th an $5 00 ,00 0 in no ne co no m ic da m ag es , reg ard le ss of t he nu m be r of cla im an ts . (b ) Not withs ta nd in g parag rap h (a), if th e ne gl ig en ce res ul te d in a pe rm an en t ve ge ta ti ve st at e or de ath, th e t ot al no ne co no m ic da m ag es re co ve ra ble from al l pr act it io ne rs , reg ard le ss of th e nu m be r of cl ai m an ts, un de r th is pa rag rap h s ha ll no t ex ceed$1 m il li on . . . . (c) The to ta l no ne co no m ic da m ag es reco ve rab le by al l cl ai m an ts fro m al l pr act i t i o n er de fen da nt s un de r th is subs ect io n sh al l no t ex ceed $1 m il li on inth e ag gr eg at e. Fl a. St at . § 7 66 .11 8( 2) . The s ta tu te in cl ud es a si m il ar p ro vi si on forcla im s ag ai ns t
no np ract it io ne rs . Thatpro vi si on li m it s n on eco no m ic da m ag es to $7 50 ,00 0 p er 8cl ai m an t, o r $1 .5 m il li oninth e ag gr eg at e rec ov erab le by all c la im an ts ag ai ns t al l

no np ract it io ne r de fen da nt s. Fl a. St at . § 7 66 .11 8( 3) . The s ta tu te de fin es a

“pr act it io ne r” as :
an y pe rs on li cen se d un de r ch ap te r 45 8, ch ap te r 45 9, ch apte r 460, ch ap te r 46 1, ch ap te r 46 2, ch ap te r 46 3, ch ap te r 46 6, ch ap te r 46 7, or ch ap te r 48 6 or cert i f ie d un de r s. 46 4.0 12
. . . an y as so ci at io n, co rp or at io n, firm , pa rtn ers hi p, or ot he r bu si ne s s e nt ity un de r whi ch su ch pr act it io ne r pr act ic es or an y em

pl oyee of su ch pr act i t i o n e r o r en ti ty act in g in th e s co pe of hi s or he r em

pl oym en t . . . an y pe rs on or en ti ty f o r w h o m a pr act it io ne r is vi cari ou sl y li ab le an d an y pe rs on or en ti ty who se li ab il it y is ba se d so le ly on su ch pe rs on or en ti ty be in g vi cari ou sl y li ab le fo r th e act io ns of apra ct it io ne r. Fl a. St at . § 7 66 .11 8( 1) (c). Th e st atut e d oe s n otde fin e th e te rm “ no np ract it io ne r.” On ap pe al Pla in ti ffs arg ue forth e fi rs t t im e th atth ey sh ou ldhave reco ve red $1 m il li on ag ai ns t Eg li n Ai r Fo rce B as e Hos pi ta l as a no np ract it io ne r be cau se it

“ is in de pe nd en tl y

li ab le forit s o wn b reac he s o f du ty und er Fl or id a la w” fo r it s

“ syste m ic ” n eg li ge nc e. Pla in ti ffs waiv edth atarg um en t b y fai li ng to rai se itbe fo re th e Dis tri ctCo urt. See Acces s No w, Inc . v. Sw. Airl in es Co ., 38 5 F .3d13 24 , 13 31 (1 1t h C ir. 2 00 4) (“ [A]n is su e n otrai se d i n t he di st ric t co urt an d ra is edforth e fi rs t ti m e in anap pe al wil l n otbe co ns id eredby thi s co urt.” ( qu ot at io n m ark s o m it te d) ). Pl ai nt iff s d idno t al le ge inth ei r co m pl ai ntth atth e h os pi ta l i ts el f was di rect ly li ab le forit s n eg li ge ntact io ns in de pe nd en t o f th os e o f it s emplo y ees . Nordi d Pl ai nt iff s ra is e th atarg um en t i n t he ir m ot io n t o a lt er o r am en d t he jud gm en t.
9Rat he r, in th atm ot io n P la in ti ffs arg ue d t ha t the ho sp it al sh ou ldbe he ld vi ca ri ou sl y li ab le forth e n eg li ge nc e o f it s emplo y ees . The Dis tri ctCo urt p ro pe rly fou ndth atan y no ne co no mic dam ag es
reco ve rab le fro m

th e h os pi ta l b as edon it s v ic ari ou s l iabi li ty fell withi n t he $1
m il li on cap for“pr act it io ne rs .” Flo rid a’s st atut e ex pr es sl y pro vi de s t ha t “ th e te rm ‘pract it io ne r’ inc lu de s . . . any pers on or e nt ity who se li ab il it y

is ba se d s ol el y

on
su chpe rs on or e nt it y

be in g v ic ari ou sl y

li ab le forth e act io ns of apra ct it io ne r.” Fl a. St at . § 7 66 .11 8( 1) (c). Th e Dis tri ctCo urt al so co rrec tl y ch arac te riz edth e cert ifi edreg is te rednu rs e an es th et is t, the fam il y pra ct ic e d oc to rs an d t he ob st etric ia n wh o p ro vi de d M s. M cCa ll ’s m ed ic al care at t he Fo rt Walt on Beac h Med ic al Cen te r as “pr act it io ne rs .” See Fl a. St at . §§ 76 6.1 18 (1 )(c) , 46 4.0 12 , 2 45 8.3 11
. The Dis tri ctCo urt was co rrec t i n fi nd in g t ha t Pl ai nt iff s d idno t es tabl is h t ha t Ms . McCa ll ’s dea th res ul te d fr om th e n eg li ge nc e o f a “ no np ract it io ne r.” As the Dis tri ctCo urt o bs erv ed , Pla in ti ffs ’ co m pl ai ntdi d n otid en ti fy

an y ho sp it al st aff o r
nu rs es by nam e ex cep t fo r th e p hysic ia ns , who are p ract it io ne rs . The Di st ric t Co urt al so rep orte d t ha t “ no ev id en ce attri al si ng le d o uta sp eci fic no np ract it io ne r

Plaintiffs conce ded this point before the District Court and do not ar gue other wise on 2 appea l. 10fo r ne gl ig en t co nduc t.” Ou r in de pe nd en t re vi ew of th e tr ia l re co rdco nf

irms th at fin di ng . Whi le Pla in ti ffs ’ ex pe rt i n o bs te tri cs an d g yne co lo gy op in edab ou t the
ne gl ig en ce o f th e nur se an es th et is t, fa m il y pra ct ic e d oc to rs an d o bs te tri ci anwho pr ov id edm ed ic al care to Ms . McCa ll , th e ex pe rt d idno t d is cu ss th e p ot en ti al
ne gl ig en ce o f an y

ot he r m em

be rs of t he ho sp it al st aff. Onth is reco rd , we
co nc lu de th atth e Dis tri ctCo urt d idno t err in ap pl y in g F lo rid a’s cap on
no ne co no m ic da m ag es form ed ic al m al pr act ic e cl ai m s. IV. Pl ai nt iff s n ex t ch al le ng e th e cap un de r se ve ral pro vi si on s o f th e Fl or id a an d Uni te d S ta te s C on st itut io ns . W e fi rs t ad dr es s Pl ai nt iff s’ arg um en t tha t the cap vi ol at es th e Uni te d S ta te s C on st itut io n. We th enrev ie w Pla in ti ffs ’ ch al le ng e to th e cap un de r th e Tak in gs Claus e o f th e Fl or id a Co ns ti tu ti on , Art. X, § 6 , bec au se Fl or id a co ns ti tu ti on al law o n t he m at te r is well set tl ed . Flo rid a co ns ti tu ti on al law
on th e o th er p ro vi si on s o f th e Fl or id a Co ns ti tu ti on un de r whi chPla in ti ffs ch al le ng e th e st atut ory

cap , ho wev er, i s u ns et tl ed . For t hi s re as on , we wil l ce rti fy
se ve ral qu es ti on s o f st at e co ns ti tu ti on al law t o t he Flo rid a Supr em e Co urt u nd er i ts cert ifi cat io n p ro cedur e.

11A.

Pl ai nt iff s ar gu e th atFlo rid a’s st atut ory cap onno ne co no m ic da m ag es for
m ed ic al m al pr act ic e cl ai m s v io la te s t he Equ al Pro te ct io n C laus e o f th e Fo urte en th Am en dm en t o f th e Uni te d S ta te s C on st itut io n. Un de r th e Equ al Pro te ct io n C laus e,

“ [s ]oci al an d e co no m ic leg is la ti on . . . th atdo es no t em pl oy sus pe ctcla ss ifi cat io ns
orim pi ng e o n fu nd am en ta l ri gh ts m us t b e uph el d a ga in stequa l p ro te ct io n a tt ack whe n the leg is la ti ve m ean s ar e rat io na ll y rel at edto a le gi ti m at e g ov ern m en ta l pu rp os e.” Hod el v. In di an a, 45 2 U.S. 3 14 , 33 1, 1 01 S. Ct. 2 37 6, 2 38 7 (1 98 1) ; s ee al so U.S. R.R. Ret . Bd. v . Frit z, 44 9 U.S. 1 66 , 17 5, 1 77 , 10 1 S . Ct. 4 53 , 45 9– 60 (1 98 0)
. W e rejectPla in ti ffs ’ arg um en t tha t s tri ctor i nt erm ed ia te scrut in y ap pl ie s t o
ou r rev ie w of t he st atut e und er the Equ al Pro te ct io n C laus e o f th e Uni te d S ta te s Co ns ti tu ti on . Plai nt iff

s h av e n otid en ti fie d h ow the st atut e b ur de ns a fu nd am en ta l rig htor draws a su sp ectcla ss ifi cat io n u nd er fe de ral law. We the refo re an al y ze whe th er Fl or id a’s st atut ory cap is rat io na ll y

rel at edto a le gi ti m at e g ov ern m en ta l pu rp os e. See Ho de l, 4 52 U.S. at 3 31 , 10 1 S . Ct. at23 87 . Whe n app lying rat io na l ba si s re vi ew, we m

us t uph ol d the st atut e ag ai ns t an equa l p ro te ct io n c ha ll en ge “ if th ere i s an y

reas on ab ly con cei vabl e st at e o f fac ts th atco ul d p ro vi de a rat io na l ba si s fo r th e cl as si fic at io n.” FCC v . Beac h C omm c’ns , Inc ., 50 8 U.S. 3 07 , 31 2,
1231 3, 1 13 S. Ct. 2 09 6, 2 10 1 (1 99 3) . “ [T]hos e atta ck in g t he rat io na li ty of th e

le gi sl at iv e cl as si fic at io n h av e th e b ur de n t o n eg at iv e ev ery co nc ei vabl e b as is whi chm ig htsupp ort i t.” Id . at 3 15 , 11 3 S . Ct. at21 02 (qu ot at io n m ark s o m it te d)
. Inen act in g t he st atut ory

cap , th e Fl or id a le gi sl atur e rep orte d t ha t a r ecen t, dr am at ic in crea se inm ed ic al m al pr act ic e li ab il it y in su ran ce p rem iu m s h ad in crea se d t he co stof m ed ic al care an d d ecre as edth e av ai labi li ty of m al pr act ic e in su ran ce. See Fla . Sta t. § 76 6.2 01 (1 )(a) . The l eg is la tu re o bs erv edth at“ [t]he pr im ary cau se of i nc reas edm ed ic al m al pr act ic e li ab il ity in su ran ce p rem iu m s h as be enth e subs ta nt ia l i nc reas e in lo ss pa ym en ts to cla im an ts cau se d b y tre m en do us in crea se s i n t he am ou nt s o f pa idcla im s.” Id . § 7 66 .20 1( 1) (b ). The l eg is la tu re
crea te d t he st atut ory

cap on no ne co no m ic dam ag es inaneffo rt t o m ak e
m al pr act ic e in su ran ce ea si er t o o bt ai n a ndreduc e th e co stof m ed ic al care . See i d. § 7 66 .20 1( 1)
. Pl ai nt iff s ar gu e th atth e st atut ory

cap lac ks a rat io na l b as is be cau se th e Fl or id a le gi sl atur e “ ha d n o o bjec ti ve , factua l b as is forbe li ev in g” th ata cap on
no ne co no m ic da m ag es form ed ic al m al pr act ic e cl ai m s wo ul d re du ce the co stof
m ed ic al m al pr act ic e in su ran ce. Tha t ar gu m en t l ack s m eri t. Bef or e en act in g t he st atut ory cap , th e Fl or id a le gi sl atur e’s Sel ectCo m m it te e p rep areda rep ort o n t he is su e. See Fl or id a Hou se of R ep res en ta ti ve s, Se le ctCo m m it te e o n M ed ic al
13Liab il it y

Ins ur an ce Re po rt ( 20 03 ) at 4 . Befo re i ss ui ng th e rep ort the leg is la tu re 3 he ldpubl ic he ari ng s, h eardex pe rt t es ti m on y an d re vi eweda se pa rat e rep ort pr ep aredby G ov ern orBu sh ’s TaskFo rce o n Hea lt hc are P ro fes si on al Liab il it y In su ran ce. Id . The Tas k F or ce re po rt s etforth th athe al th care pro vi de rs were ch an gi ng th e sc op e o f th ei r pr act ic e, le av in g F lo rid a, orret iri ng be cau se of
es cal at in g m ed ic al m al pr act ic e p rem iu m s. Id . at 1 5. Th e Tas k F or ce
reco m m en de d t ha t the leg is la tu re cr eat e a “pe r in ci de nt ” m ed ic al m al pr act ic e cap to rem edy

th e p ro bl em . Id. at55
. By th ei r arg um en t, Pl ai nt iff s as k u s t o s eco ndgu es s t he leg is la tu re’s jud gm en t i n e na ct in g a“pe r in ci de nt ” rat he r th an“pe r cl ai m an t” st atut ory cap . Howev er, “ equa l p ro te ct io n i s n ota li cen se forco urts to jud ge th e wis do m , fai rn es s, o r lo gi c o f le gi sl at iv e ch oi ces .” Beac h C omm c’ns , Inc ., 50 8 U.S. at31 3, 11 3 S . Ct. at21 01 . The l eg is la tu re i de nt ifi eda le gi ti m at e g ov ern m en ta l p ur po se in pa ss in g t he st atut ory

cap , nam el y

to reduc e th e co stof m ed ic al m al pr act ic e
Available at 3 http://www.myfloridahouse .g ov/Sections/Documents/loaddoc.aspx? PublicationTy pe=Committee s&CommitteeI d=2147& Session=2003&D ocumentTy pe=G ener al%20Publications&F ileName= 2 103.pdf#xm l=http://s ear ch/texis /searc h/pdfhi.tx t? query =Report+ of+Sele ct+Committee+on+ Medi cal+ L iability+Insuranc e& pr=PROD_MF HMain& rdepth= 0&or der=r& mode=a dmin&cq= &id= 44 8e02b99 (la st visit ed May 26, 2011). Pursuant to Interna l Opera ting Proc edure 10, Citation t o Interne t Materials in an O pinion, under Fe dera l Rule of Appellate Proc edure 36, a copy of the interne t materials cited in this opinion is available at the Eleve nth Circuit Court of Appeal’s Cler k’s Off ice. 14pr em iu m s an d h eal th care . See Fl a. St at . § 7 66 .20 1. Th e m ean s t ha t Fl or id a

ch os e, a p er i nc id en t cap o n n on eco no m ic dam ag es , bea rs a rat io na l re la ti on sh ip to th aten d. Th e Fl or id a le gi sl atur e co ul d re as on ab ly hav e co nc lu de d tha t s uc h acap
wou ldreduc e d am ag e award s an d i n turn m ak e m ed ic al m al pr act ic e in su ran ce
m or e aff or dabl e an d h eal th care m or e av ai labl e. W e th eref or e co nc lu de th at Fl or id a’s st atut ory

cap on no ne co no m ic da m ag es form ed ic al m al pr act ic e cl ai m s do es no t v io la te th e Equ al Pro te ct io n C laus e o f th e Uni te d S ta te s C on st itut io n. B. Pl ai nt iff s n ex t ar gu e th atFlo rid a’s st atut ory cap co ns ti tu te s a t ak in g o f pr op erty witho utjus t co m

pe ns at io n i n v io la ti on of Art ic le X, Sect io n 6 of the Fl or id a Co ns ti tu ti on an d t he Fif th Am en dm en t o f th e Uni te d S ta te s C on st itut io n. W e d is ag ree. Th e Tak in gs Claus e o f th e Uni te d S ta te s C on st itut io n p ro vi de s t ha t

“pr iv at e p ro pe rty” sh al l n ot“be tak enforpubl ic us e, witho utjus t co m pe ns at io n.” U.S. Con st . Am en d V. The Taki ng s C laus e “ do es no t u nd ert ak e . . . to s oc ia li ze al l l os se s, b utth os e o nl y

whi chres ul t fr om

a ta ki ng of p ro pe rty.” Unit edSta te s v . W il lo w Riv er Po wer Co ., 32 4 U.S. 4 99 , 50 2, 6 5 S . Ct. 7 61 , 76 4 (1 94 5)
.

“ [A]lth ou gh a ve st edcau se of a ct io n i s p ro pe rty andis pro te ct edfro m arb it rary in te rfer en ce, [a l it ig an t] has no pro pe rty, in the co ns ti tu ti on al sen se , inan y pa rti cu la r fo rm

of r em edy

. . . .” Gib be s v . Zim

m erm an , 29 0 U.S. 3 26 , 33 2, 5 4 S
. 15Ct . 14 0, 1 42 (19 93 ) (an al y zi ng ch al le ng e to a st at e st atut e und er the Due P ro ces s

Cl au se ). Flo rid a’s st atut ory cap do es no t i nt erfe re wi th a ve st edrig ht . “ No p ers on ha s a v es te d i nt eres t i n a ny rul e o f la w, ent it li ng hi m to in si stth atitsh al l re m ai n
un ch an ge d fo r hi s b en efi t.” New Yo rk Cen t. R.R. v . W

hi te , 24 3 U.S. 1 88 , 19 8, 3 7 S. Ct . 24 7, 2 50 (19 17 ). Mo reo ve r, Flo rid a p as se d i ts st atut ory cap in20 03 , lo ng be fo re the Pla in ti ffs ’ cau se of a ct io n fo r th e m ed ic al ne gl ig en ce tha t t oo k p la ce i n 20 06 ve st ed . See 2 00 3 F la . Ses s. Law Serv. 4 16 (W es t). We th eref or e co nc lu de th atFlo rid a’s cap do es no t co ns ti tu te a ta ki ng un de r th e Uni te d S ta te s Co ns ti tu ti on . Noris th e cap a ta ki ng un de r wel l-e st ab li sh edFlo rid a co ns ti tu ti on al law. Fl or id a’s Tak in gs Claus e p ro vi de s t ha t “ [n ]o pri va te pro pe rty sh al l b e ta ke n e xc ep t fo r a p ub li c p ur

po se an d wi th ful l co m

pe ns at io n t he refo r pa idto each own er o r
se cu redby dep os itinth e reg is try of the co urt an d ava il ab le to th e o wne r.” Fl a. Co ns t. Art . X, § 6( a). “ Fl or id a la w is well est ab li sh edth atth e ri gh t t o s ue onan in ch oa te cau se of a ct io n— on e th atha s n oty etaccr ue d— is no t a v es te d ri gh t be cau se no on e h as a ve st edrig htinth e co m m on law . . . .” Rap ha el v. Sh ect er, 1 8 So . 3d11 52 , 11 57 (Fl a. 4t h DCA 2 00 9) (qu ot at io n m ark s o mit te d) . Becau se Fl or id a’s st atut ory

cap do es no t d ep riv e Pl ai nt iff s o f a v es te d ri gh t, the re i s n o ta ki ng withi n t he m ean in g o f th e Tak in gs Claus e o f th e Fl or id a Co ns ti tu ti on . 16V.

Bec au se th is cas e rai se s i m po rta ntqu es ti on s ab ou t the in te rp ret at io n a nd ap pl ic at io n o f Fl or id a co ns ti tu ti on al law i n areas th atrem ai n uns et tl ed , we wil l n ot de ci de Pla in ti ffs ’ rem ai ni ng st at e co ns ti tu ti on al cla im s, bu t ra th er wi ll gra nt 4 Pl ai nt iff s’ m ot io n t o c ert ify qu es ti on s re la ti ng to th os e cl ai m s t o t he Flo rid a Supr em e Co urt. See Fl a. Co ns t. art. V, § 3 (b )(6 ); F la . R. App . P. 9.1 50 (“ On 5 ei th er i ts ownm ot io n o r th atof apa rty, . . . a Uni te d S ta te s co urt o f ap pe al s m ay cert ify a qu es ti on of l aw to th e Supr em e Co urt o f Fl or id a if th e an swe r is de te rm in at iv e o f th e cau se an d t he re i s n o c on tro ll in g p rece de ntof t he Supr em e

We deny Plaintiffs’ motion to certify questions about the constitutionality of the c ap 4 under the TakingClause, Article X, Section 6(a ), of the F lorida Constitut ion and about the application of the cap to the f acts of this ca se. We have a ddresse d the merits of those c laims under F lorida law. We a lso deny Plaintiffs’ motion to certify a question about the constitutionality

of the c ap under

the Due Proc ess Clause, Ar ticle I , Section 9, of the F lorida Constitution. Pl aintiffs wa ived their due proce ss claim by failingto addre ss it on the merits in their brief s. See Gre enbria

r, Ltd. v. City

of Alaba ster, 881 F .2d 1570, 1573 n.6 (11th Cir. 1989) (notingthat an issue is waive d if the par ty fails to argue the merits of the issue in its briefs). 5 The particular phrasing used i n the cert ified question is not to restric t the S upreme Court’s considerations of the problems involved and the issues as the Supreme Court perc eives them to be in its analy sis of the rec ord cer tified in this case . This latitude extends to the Supreme Court’s restate ment of the issue or issues and the manner in which the answe rs are to be g iven, whet h er as a compre hensive whole or in subordinate or

even c ontinge nt parts. Ander son v. J ackson Mun. Air port Auth., 645 F.2d 401, 403 n.5 ( 5th Cir. 1981) (quotation marks omitted). In Bonne r v. City of Prichar d, 661 F.2d 1206, 1209 ( 11th Cir. 1981) (en ba nc), w e adopted a s binding pre cede nt all decisions of the for mer F ifth Circuit handed down be fore October 1, 1981. 17Co urt o f Fl or id a.”). “ Whe re the re i s d oubtinth e in te rp ret at io n o f st at e la w, a

fed eral co urt m ay

cert ify the qu es ti on to th e st at e supr em e co urt t o a vo idm ak in g
un ne ces sary

Erie g ue ss es an d t o o fferth e st at e co urt the op po rtu ni ty to i nt erp retor ch an ge ex is ti ng law.” Un io n P la nt ers Ban k, N.A. v. New Yo rk , 43 6 F .3d13 05 , 13 06 (11 th Cir . 20 06 ) (quo ta ti on m ark s o mit te d) . W e certi fy th e fo ll owi ng qu es ti on s t o t he Supr em e Co urt o f Fl or id a: (1 ) Doe s t he st atut ory

cap on no ne co no m ic da m ag es , Fla . Sta t. § 76 6.1 18 , vi ol at e th e ri gh t t o e qu al pro te ct io n u nd er Art ic le I, Sect io n 2 of t he Flo rid a Co ns ti tu ti on ? (2 ) Doe s t he st atut ory

cap on no ne co no m ic da m ag es , Fla . Sta t. § 76 6.1 18 , vi ol at e th e ri gh t o f acc es s t o t he co urts un de r Arti cl e I, Sec ti on 21 of the Fl or id a Co ns ti tu ti on ? (3 ) Doe s t he st atut ory

cap on no ne co no m ic da m ag es , Fla . Sta t. § 76 6.1 18 , vi ol at e th e ri gh t t o t ria l b y jury un de r Arti cl e I, Sec ti on 22 of t he Flo rid a Co ns ti tu ti on ? 6 (4 ) Doe s t he st atut ory

cap on no ne co no m ic da m ag es , Fla . Sta t. § 76 6.1 18 , vi ol at e th e se pa rat io n o f po wers gu aran te edby Arti cl e II, Sec ti on 3 an d Arti cl e V, Sect io n 1 of t he Flo rid a Co ns ti tu ti on ?

The District Court conc luded that “be cause this is an FTCA ca se, the plaintiffs ha d no 6 right to trial by

jury in the first place , and the c ourt there fore has no occ asion to consider [P laintiffs’ argument that the ca p violates the right to trial by jury].” Plaintiffs argue that the District Court did have occ asion to consider the ir argument beca use the F TCA waives sove reign immunit y and authorizes tort actions ag ainst the United States “in the same manner and to the same e x tent as a private individual under like c ircumstance s.” See United States v. Orlea ns, 425 U.S. 807, 813, 96 S. C t. 1971, 1975 (1976). Plaintiffs arg ue that, if the statutory

cap violate s the right to jury

trial in state suits ag ainst private pa rties, the ca

p is void in the state c ourts, there fore , it is voi d in the FTCA c ontextas we ll. W e agree with Plainti ffs a nd there fore cer

tify this question to the Florida Supre me Court. 18VI.

W e aff irm th e d is tri ctco urt’s ap pl ic at io n o f Fl or id a’s st atut ory cap on
no ne co no m ic da m ag es . W e al so co nc lu de th atth e cap co m po rts with t he Equ al Pro te ct io n a ndTaki ng s C laus es of t he Uni te d S ta te s C on st itut io n. We con cl ud e th atth e st atut e d oe s n otco ns ti tu te a ta ki ng invi ol at io n o f th e Tak in gs Claus e o f th e Fl or id a Co ns ti tu ti on , andwe gr an t Pl ai nt iff’s m ot io n t o c ert ify qu es ti on s reg ard in g P la in ti ffs ’ rem ai ni ng ch al le ng es to th e cap un de r st at e co ns ti tu ti on al law to th e Fl or id a Supr em e Co urt. AFFIR MED, inpa rt, a ndQUESTIONS CERTIFIED. Pl ai nt iff s’ Mo ti on to Cert ify Ques ti on s, GRANTED, inpa rt, a ndDENIED, in pa rt.

19