South Florida Personal Injury Lawyers Blog
Last updated September 25, 2026 · Reviewed by Carolyn Friedman Frank
Florida law can require an administrative law judge to rule on a baby’s brain injury at delivery before any lawsuit over that injury goes forward in circuit court. On July 8, 2026, the Third District Court of Appeal applied that rule to a Miami-Dade case in which parents had sued a hospital and its executives in a lawsuit separate from their case against the doctors who delivered their child. The decision, Mount Sinai Medical Center of Florida, Inc. v. Esposito, puts the NICA question at the front of a Florida birth injury lawsuit even when the claim is aimed at hospital systems.
NICA is the Florida Birth-Related Neurological Injury Compensation Plan, a no-fault system that compensates a limited class of catastrophic birth injuries in place of a malpractice suit. Florida Statute § 766.304 gives the administrative law judge exclusive jurisdiction to decide whether a claim is compensable under the plan, and it provides that no civil action may be brought until the judge has made the determinations listed in Florida Statute § 766.309. For families working with our Miami medical malpractice attorneys, the first contested question is often whether the injury falls inside NICA at all, and the negligence case waits on the answer.
What the Judge Decides Before a Lawsuit Can Proceed
Florida Statute § 766.309 lists what the administrative law judge decides. The judge rules on whether the injury is a birth-related neurological injury, whether a participating physician delivered the obstetrical services in a hospital, how much compensation is awardable, and, if a party raises it, whether the patient notice requirements of Florida Statute § 766.316 were met.
A birth-related neurological injury is an injury to the brain or spinal cord of a live infant, caused by oxygen deprivation or mechanical injury during labor, delivery, or resuscitation in the immediate postdelivery period in a hospital, that leaves the infant permanently and substantially mentally and physically impaired. Florida Statute § 766.302(4) sets that definition. It also requires a birth weight of at least 2,500 grams, or 2,000 grams in a multiple gestation, and it excludes injuries caused by genetic or congenital abnormality.
The judge’s ruling sends the family one of two ways. If the claim is compensable, Florida Statute § 766.303(2) makes the plan’s remedies exclusive against anyone directly involved with the labor, delivery, or immediate postdelivery resuscitation, with a narrow exception for clear and convincing evidence of bad faith, malicious purpose, or willful and wanton disregard of human rights, safety, or property. If the claim is not compensable, § 766.304 lets the family pursue its civil remedies, and the administrative ruling does not bar the suit.
How Esposito Reached Executives Who Were Not in the Delivery Room
The Esposito parents attributed their infant’s neurological injury to a delayed cesarean section. They filed one lawsuit against the hospital and several non-clinician executives, including the chief executive officer and the vice presidents for risk management and for patient safety, alleging the executives failed to put systems and processes in place to guard against that delay. A companion suit against the two delivering obstetricians and the hospital was referred to the administrative law judge.
The trial court kept the executives’ case in circuit court. It reasoned that the case concerned procedures and protocols, that the executives were said not to be NICA participants, and that none had been personally involved in the delivery.
The appellate court disagreed on the threshold question. The parents had alleged a birth-related neurological injury, the hospital and executives had invoked NICA immunity, the companion case had already been abated, and participating obstetricians had delivered the baby. Taken together, the court held, those facts made a compensability determination by the administrative law judge a precondition to maintaining the suit.
What the Ruling Leaves Open for a NICA Birth Injury Lawsuit in Florida
The court granted the petition only in part. It quashed the trial court’s order to the extent the order bears on the threshold compensability issue and went no further, citing concerns about administrative judges deciding private rights. The opinion does not decide whether executives who never treated the mother count as persons directly involved with the labor and delivery under § 766.303(2), and it states that it is not final until any timely motion for rehearing is resolved.
Friedman Rodman Frank & Estrada has represented injured people and their families across Miami-Dade and Broward Counties since 1976, and we prepare for the NICA hearing in a birth injury case with the civil case in view. Under § 766.304, the judge’s findings are not admissible in a later proceeding, although sworn testimony and exhibits from the administrative case may be used for impeachment in a later civil action against a party to it.
Getting a Birth Injury Claim Reviewed in Miami-Dade
Whether a birth injury belongs before an administrative law judge, in circuit court, or in both in sequence depends on facts about the delivery, the physicians, and the hospital that a family can begin gathering now. Friedman Rodman Frank & Estrada reviews these claims for parents across South Florida from our Miami office. We offer a free consultation on any injury or workers’ compensation claim. Call (305) 448-8585 or contact us online to get started.