This Florida appellate decision provides a detailed analysis of the Daubert standard as applied to medical causation experts in a wrongful death case involving an infant's death from pertussis. The ruling underscores the rigorous reliability requirements that expert testimony must meet to survive judicial gatekeeping, particularly when establishing causation in complex medical cases.

Florida Appellate Court Affirms Exclusion of Causation Experts Under

Daubert and Summary Judgment in Medical Malpractice Wrongful Death

Action Involving Infant's Death from Pertussis

Court: District Court of Appeal of Florida, Fifth District (Appeal from the

Circuit Court for Lake County, Hon. Danny Ray Mosley, Judge)

Date: January 30, 2026 --- 2026 WL 247408

Introduction

On March 31, 2019, two-month-old A.S. was brought to Leesburg Regional

Medical Center with a cough, paleness, and lethargy. The doctor found

her lungs clear and ordered albuterol treatment. She was discharged that

afternoon. The next day, A.S. returned with worsened symptoms and oxygen

saturation at 78%. Blood tests revealed an extremely elevated white

blood cell count of 58,200. She was transferred to a second hospital

where she was diagnosed with pertussis (whooping cough)---a disease she

had not yet been vaccinated against due to her age. Antibiotics

(azithromycin) were administered near midnight on April 1 without

improvement. Her white blood cell count rose to 81,000, she was

intubated April 4, and she tragically died on April 6, 2019. This case presents important questions about whether the trial court abused its discretion in.

The Procedural Background

Gregory L. Williams, as successor personal representative of the Estate

of Addilyn Leeann Shirer, filed a medical malpractice complaint against

the hospital, an emergency services company, the treating physician, a

nurse, and a respiratory therapist. The Estate sought to introduce four

causation experts. The trial court excluded two sets of experts under

Daubert and Fla. Stat. § 90.702, finding their opinions on causation

unreliable. With no admissible expert testimony on causation, the trial

court granted summary judgment for defendants. The Estate appealed the

Daubert exclusions. The question before the appellate court was whether this order could be reviewed at that stage of the litigation.

The Legal Issue at Stake

Whether the trial court abused its discretion in excluding four medical

experts under the Daubert standard for failing to reliably establish

that a 12--36 hour delay in administering antibiotics more likely than

not caused the infant's death from pertussis. Secondary issue: whether

the court's reliance on deposition transcripts rather than a live

hearing warranted less deference on review.

Arguments Presented to the Court

Estate (Appellant): Argued the trial court improperly conflated the

time delay with the stage of disease progression, and that the experts'

opinions---based on medical literature and clinical experience---were

sufficiently reliable to assist the jury. Also argued less deference was

warranted because the court relied on deposition transcripts.

Defendants (Appellees): Argued the experts could not scientifically

establish that earlier antibiotic administration would more likely than

not have changed the outcome, and that the trial court properly applied

Daubert's reliability requirements.

The Court's Holding

Affirmed. The trial court did not abuse its discretion in excluding any

of the Estate's four experts.

Detailed Analysis and Reasoning

The court reviewed each expert's testimony and found none could reliably

establish that earlier antibiotic administration would more probably

than not have saved A.S. Drs. Penkoske and Hull could not provide a

scientifically reliable basis for their causation opinions---both

acknowledged they could not determine how much earlier treatment would

have needed to be given. Dr. Snow admitted there were no studies on the

impact of antibiotics on the toxins that ultimately cause pertussis

death. Dr. Rimawi acknowledged he did not know the efficacy of

antibiotics based on a particular day in disease progression. The court

held that while experts need not establish causation conclusively, a

reasonable judge could find the testimony was not sufficiently reliable

and would not assist the jury in determining whether the delay more

likely than not caused A.S.'s death.

This reasoning demonstrates the court's careful application of precedent to distinguish between different legal doctrines. The analysis provides clarity on how courts should interpret similar statutes and apply appellate procedure rules.

Practical Significance for Legal Practitioners

This decision is important for practitioners because it clarifies the court reviewed each expert's testimony. Understanding the court's reasoning helps attorneys avoid procedural pitfalls and develop effective litigation strategies.

Key practice points include:

• The importance of carefully analyzing the specific language and scope of statutory provisions
• How appellate jurisdiction depends on the type of legal protection or immunity being asserted
• The procedural consequences of mischaracterizing the nature of a defense

Practitioners should carefully consider how this holding applies to their own cases and adjust their litigation approaches accordingly.

This case summary is provided for educational and informational purposes only. It should not be construed as legal advice. Practitioners should consult with qualified legal counsel regarding their specific situations.

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