Philip Morris USA v. Gloger , 273 So. 3d 1046 ( 2019 )


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  •        Third District Court of Appeal
    State of Florida
    Opinion filed March 20, 2019.
    Not final until disposition of timely filed motion for rehearing.
    ________________
    No. 3D18-341
    Lower Tribunal No. 11-23377
    ________________
    Philip Morris USA, Inc., et al.,
    Appellants,
    vs.
    Kenneth Gloger, etc.,
    Appellee.
    An Appeal from the Circuit Court for Miami-Dade County, David C. Miller,
    Judge.
    King & Spalding LLP, and William L. Durham II and Val Leppert (Atlanta,
    Georgia), for appellant R.J. Reynolds Tobacco Company; Shook, Hardy & Bacon
    LLP, and Laura K. Whitmore (Tampa); Arnold & Porter Kaye Scholer LLP, and
    Keri L. Arnold and Geoffrey J. Michael (Washington, DC), for appellant Philip
    Morris USA Inc.
    Crabtree & Auslander, and John G. Crabtree, Charles M. Auslander, Linda
    A. Wells, Brian C. Tackenberg and Emily Cabrera, for appellee.
    Before EMAS, C.J., and SCALES and HENDON, JJ.
    SCALES, J.
    In this Engle1 progeny wrongful death action, Phillip Morris USA Inc. and
    R.J. Reynolds Tobacco Company, the defendants below (collectively, the “tobacco
    defendants”), appeal a final judgment entered pursuant to a jury verdict in favor of
    the plaintiff below, Kenneth Gloger, as personal representative of the estate of his
    wife, Irene Gloger. The tobacco defendants challenge various aspects of the trial
    conducted below, one of which merits discussion and warrants reversal.
    Specifically, because we conclude that the trial court abused its discretion in
    permitting Mr. Gloger to testify, without limitation, that Mrs. Gloger’s initial,
    treating physicians (both oncologists, who did not testify at trial) told the Glogers
    that Mrs. Gloger had primary lung cancer caused by smoking cigarettes, we
    reverse the final judgment and remand the case for a new trial.2
    I.    RELEVANT FACTS AND PROCEDURAL BACKGROUND
    In July 2011, Kenneth Gloger, as personal representative for the estate of his
    deceased wife, Irene Gloger, filed the instant wrongful death action against the
    tobacco defendants and others in the Miami-Dade County Circuit Court. The
    second amended complaint alleged, in relevant part, that: (i) Mrs. Gloger had
    contracted lung cancer as a result of smoking cigarettes manufactured, advertised,
    marketed, and sold by the tobacco defendants; (ii) Mrs. Gloger’s death, on
    1   Engle v. Liggett Grp., Inc., 
    945 So. 2d 1246
    (Fla. 2006).
    2 Given our resolution of this matter, we need not, and do not, reach any of the
    other issues raised on appeal.
    2
    November 22, 1996, was a direct and proximate result of her addiction to smoking
    the tobacco defendants’ cigarettes; and (iii) the Glogers and their children have
    Engle class member status. The tobacco defendants specifically denied these
    allegations.
    The lower court ordered that trial be conducted in two phases. In phase 1,
    the jury verdict form asked the jury to decide: (i) whether Mrs. Gloger was
    addicted to cigarettes containing nicotine, and if so, was such addiction a legal
    cause of lung cancer and death; (ii) whether smoking cigarettes manufactured by
    the tobacco defendants was a legal cause of Mrs. Gloger’s lung cancer and death;
    (iii) the percentage of fault between Mrs. Gloger and the tobacco defendants; (iv)
    whether concealment or omission of material information concerning the health
    effects or addictive nature of smoking cigarettes sold by the tobacco defendants
    was a legal cause of Mrs. Gloger’s lung cancer and death; and (v) whether the
    furtherance of the tobacco defendants’ agreement with other tobacco companies to
    conceal or omit material information concerning the health effects or addictive
    nature of smoking cigarettes was a legal cause of Mrs. Gloger’s lung cancer and
    death.     Based on these findings, the jury was asked to award compensatory
    damages and to determine whether an award of punitive damages was warranted.
    In phase 2, the jury verdict form asked the jury to determine the amount of punitive
    damages to award against the tobacco defendants.
    3
    Prior to trial, on October 6, 2017, the tobacco defendants filed a motion in
    limine seeking to exclude, as hearsay, any out-of-court statements made to the
    Glogers by non-testifying doctors about the origin and progression of Mrs.
    Gloger’s cancer. Specifically, the tobacco defendants sought to preclude Mr.
    Gloger from testifying that the two oncologists (Drs. Sinkovics and Altemose)
    who, in 1995 and early 1996, initially treated Mrs. Gloger for her cancer, told the
    Glogers that Mrs. Gloger had lung cancer caused by smoking cigarettes.
    At a subsequent hearing, the trial court ruled on the tobacco defendants’
    motion in limine, finding that the oncologists’ statements to the Glogers were not
    hearsay because the statements were being offered not for their truth (i.e., whether
    Mrs. Gloger had lung cancer), but to show the “effect on listener” (i.e., the
    emotional impact Mrs. Gloger’s diagnosis with cancer had on Mr. Gloger). The
    trial court held that the subject statements were relevant to support Mr. Gloger’s
    damages claims for pain and suffering; specifically, the statements demonstrated
    “when the damages started to flow.”
    When defense counsel requested that the trial court give a limiting
    instruction to the jury that the oncologists’ statements be considered only for the
    “explicit purpose of the effect on the listener to Mr. Gloger for his damages,” the
    trial court initially denied the request, explaining:
    THE COURT: [Mr. Gloger is] going to claim that he’s suffering
    because someone told him his wife is dying of cancer. And if it was
    4
    lung cancer, fine. The issue still remains, is it lung cancer. Just
    because – there’s going to be evidence going both ways as to whether
    her lung cancer was the cause of her death. You’ll be able to argue
    that if the jury – I’m not going to instruct them. But you can certainly
    argue that. . . . I’m sorry [Mr. Gloger] began to suffer, but that doctor
    that told him that was wrong. You’re going to find that he [sic] didn’t
    die of lung cancer and, therefore, his suffering – we feel bad for him,
    but – Just like every other case, you have to prove that someone
    wasn’t hurt because of what my client did.
    (Emphasis added).
    At a later hearing, defense counsel again challenged the introduction of the
    oncologists’ statements at trial, suggesting that Mr. Gloger be limited to testifying
    that Drs. Sinkovics and Altemose told the Glogers that Mrs. Gloger had “cancer,
    that it was termina[l] cancer, deadly cancer, however the Court finds is fair and
    appropriate under the circumstances.” Citing to section 90.403 of the Florida
    Statutes, defense counsel argued that limiting Mr. Gloger’s testimony in this
    fashion eliminated the prejudice to the tobacco defendants “under a 403 analysis”
    without diminishing the impact the cancer diagnosis had on Mr. Gloger when he
    heard it. Defense counsel emphasized, “[T]hat, to us, is a solution to the problem
    of letting in back-door testimony about lung cancer from witnesses that are not
    going to be testifying in the case . . . .” The trial court declined to limit Mr.
    Gloger’s testimony in such fashion, but agreed to give a limiting instruction when
    Mr. Gloger testified about what the oncologists told him and Mrs. Gloger.
    5
    Defense counsel then filed a legal memorandum arguing that a limiting
    instruction would be insufficient, arguing again that “the proper remedy is to
    substitute the word ‘terminal’ for the word ‘lung’ when Mr. Gloger tells the jury
    about the conversations” with Drs. Sinkovics and Altemose. At trial, the lower
    court denied the tobacco defendants’ request, stating its intention to give a limiting
    instruction.
    When Mr. Gloger’s trial testimony turned to the conversations he and Mrs.
    Gloger had with Drs. Sinkovics and Altemose, the trial court gave the following
    limiting instruction:
    THE COURT: Ladies and gentlemen of the jury, Mr. Gloger is now
    going to testify about things that his doctor told . . . his wife and him.
    And these things involve his wife’s diagnosis.
    You may consider what Mr. Gloger heard to evaluate the effect
    that information had on Mr. Gloger. Based on a rule of law relating to
    hearsay, however, you may not consider what the doctors told Mr.
    Gloger for the truth of the matter asserted, just the effect the
    information had on Mr. Gloger.
    Mr. Gloger then testified, in relevant part, as follows:
    Q. [by Plaintiff’s counsel] Back to Dr. Sinkovics, so he’s a cancer
    doctor?
    A. [by Kenneth Gloger] Yes.
    Q. And he works at St. Joe’s cancer center?
    A. Yes.
    ....
    6
    Q. And so before you have the treatment, you meet with the cancer
    doctor, and did this cancer doctor, oncologist, Dr. Sinkovics, tell you
    what Irene had?
    A. He believed that she had lung cancer.
    Q. Did he tell you what it was caused by?
    A. Said it was probably caused by smoking.
    Q. After Dr. Sinkovics treated her for a while and he started some
    therapy, did there come a time when you transferred to another
    oncologist, also at the St. Joe’s cancer center who took over the care
    of Irene?
    A. Yes, that’s correct.
    Q. What was his name?
    A. His name was Dr. Rand Altemose.
    Q. And was Dr. Altemose, likewise, a cancer doctor, oncologist who
    was responsible for the treatment of your wife?
    A. Yes, he was.
    Q. And did you talk to Dr. Altemose about the cause of – strike that.
    Did you talk to Dr. Altemose about his diagnosis for Irene?
    A. Yes, we did.
    Q. And what did he say?
    A. He said it was from smoking, lung cancer.
    Q. He said she had lung cancer from smoking?
    A. Yes.
    7
    ....
    Q. And did there come a point in time where Dr. Altemose referred
    you on to Dr. Ruckdeschel[3] and the Moffitt Cancer Center?
    A. Yes.
    ....
    Q. And did you listen to Dr. Altemose and go to Moffitt Cancer
    Center?
    A. Yes, we did.
    ....
    Q. Did Dr. Ruckdeschel explain to you what he believed the –
    her diagnosis and its cause?
    A. Yes, he said she had lung cancer and he believed it was
    from smoking.
    Q. Obviously, this was tough news for you and your wife to
    hear?
    A. Yes, she was very weak at that point.
    Q. I’m talking about even going back to Dr. Sinkovics, I’m
    sorry. Going back to Dr. Sinkovics, back to 1995, the first time you
    heard it, the second time you heard it, the third time you heard it, or
    whenever you heard it.
    A. Oh, it was devastating. I – I had no idea. I mean, Irene
    was, for the most part, very healthy prior to this diagnosis.
    The jury returned a verdict in favor of the estate, finding R.J. Reynolds
    Tobacco Company fifty percent at fault, Philip Morris USA, Inc. thirty percent at
    3   Dr. John Ruckdeschel testified at trial as the estate’s expert on causation.
    8
    fault, and Mrs. Gloger twenty percent at fault. The jury awarded $7.5 million in
    compensatory damages ($2.5 million to Mr. Gloger, and $2.5 million each to the
    Glogers’s two children) and finding punitive damages were appropriate. In phase
    2 of the trial, the jury awarded $5 million in punitive damages against each of the
    tobacco defendants ($10 million total).        On February 4, 2018, the trial court
    entered a final judgment pursuant to the jury verdicts. This appeal ensued.
    II.    ANALYSIS4
    1. The out-of-court statements by Drs. Sinkovics and Altemose were offered
    to prove the “effect on listener” and, therefore, were not hearsay.
    We begin our analysis by deciding whether, as a matter of law, the subject
    out-of-court statements by Drs. Sinkovics and Altemose were hearsay in this case.
    Under the Florida Evidence Code, “[h]earsay” is defined as an out-of-court
    statement “offered in evidence to prove the truth of the matter asserted.”            §
    90.801(1)(c), Fla. Stat. (2018). While hearsay evidence is generally inadmissible
    at trial, see § 90.802, Fla. Stat. (2018), if the out-of-court statement “is offered for
    some purpose other than its truth, the statement is not hearsay and is generally
    admissible if relevant to a material issue in the case.” Penalver v. State, 
    926 So. 2d 4
    “The standard of review of a trial court’s decision on the admissibility of
    evidence is generally an abuse of discretion standard. However, the question of
    whether evidence falls within the statutory definition of hearsay is a matter of law,
    subject to de novo review.” Deutsche Bank Nat. Tr. Co. v. Alaqua Prop., 
    190 So. 3d
    662, 664 (Fla. 5th DCA 2016) (quoting Burkey v. State, 
    922 So. 2d 1033
    , 1035
    (Fla. 4th DCA 2006)).
    9
    1118, 1132 (Fla. 2006); see also § 90.401, Fla. Stat. (2018) (“Relevant evidence is
    evidence tending to prove or disprove a material fact.”).
    As the surviving spouse in this wrongful death action, Mr. Gloger was
    entitled to seek recovery for the loss of his wife’s “companionship and protection
    and for mental pain and suffering from the date of injury.” § 768.21(2), Fla. Stat.
    (2018) (emphasis added); see also Fla. Std. Jury Instr. (Civ.) 502.2(d). Consistent
    with section 768.21 and the standard jury instruction, the estate’s counsel sought to
    establish Mr. Gloger’s entitlement to damages by introducing the oncologists’ out-
    of-court statements to demonstrate the emotional impact (i.e., the “effect on
    listener”) on Mr. Gloger of hearing, for the first time, that his wife had cancer.
    Because the subject testimony was not offered to prove the truth of what was told
    to Mr. Gloger by the non-testifying doctors – i.e., that Mrs. Gloger’s cancer
    originated in her lung – it was not hearsay; and, because such evidence was
    relevant to a material issue in the case (Mr. Gloger’s damages), it was admissible
    at trial. See, e.g. Pitts v. State, 
    227 So. 3d 674
    , 678 (Fla. 1st DCA 2017) (“If a
    statement is offered to show the effect on the listener rather than the truth of the
    statement, as was the case in this instance, it is not hearsay.”); North v. State, 
    221 So. 3d 1235
    , 1237 (Fla. 2d DCA 2017) (recognizing that “an out-of-court
    statement may be admissible to establish the material effect that statement had on a
    listener – regardless of whether that statement was true or not”); Jenkins v. State,
    10
    
    189 So. 3d 866
    , 867 (Fla. 4th DCA 2015) (“Because the excluded testimony was
    not being introduced for the truth of the matter asserted but rather for the effect on
    the listener, we find that the trial court erred in excluding the statement as
    hearsay.”).
    2. The out-of-court statements by Drs. Sinkovics and Altemose were subject
    to limitation under section 90.403 of the Florida Statutes.
    Having determined that the out-of-court statements by Drs. Sinkovics and
    Altemose were not hearsay in this case, this Court turns to whether the statements
    should nevertheless have been excluded or limited under section 90.403 of the
    Florida Statutes.
    a. The trial court’s limiting instruction was not effective in this case
    Section 90.403 gives the trial court broad discretion to exclude or limit
    otherwise admissible, relevant evidence if the probative value of the evidence “is
    substantially outweighed by the danger of unfair prejudice, confusion of issues,
    misleading the jury, or needless presentation of cumulative evidence.” § 90.403,
    Fla. Stat. (2018); see Thigpen v. United Parcel Servs., Inc., 
    990 So. 2d 639
    , 645
    (Fla. 4th DCA 2008). “When a trial court considers the danger of unfair prejudice
    against the probative value of evidence, proper considerations include ‘the need for
    the evidence; the tendency of the evidence to suggest an improper basis to the jury
    for resolving the matter, e.g., an emotional basis; the chain of inference necessary
    to establish the material fact; and the effectiveness of a limiting instruction.’”
    11
    David v. Brown, 
    774 So. 2d 775
    , 777 (Fla. 4th DCA 2000) (quoting State v.
    McClain, 
    525 So. 2d 420
    , 422 (Fla. 1988)); see also Jones v. Alayon, 
    162 So. 3d 360
    , 365 (Fla. 4th DCA 2015) (same).
    Here, before Mr. Gloger testified about the Glogers’s conversations with
    Drs. Sinkovics and Altemose, the trial court gave the jury a limiting instruction,
    directing the jury “not to consider what the doctors told Mr. Gloger [about Mrs.
    Gloger’s diagnosis] for the truth of the matter asserted, just the effect the
    information had on Mr. Gloger.” While we recognize that “any prejudicial effect
    generally can be limited by giving instructions cautioning the jury as to the limited
    use of the testimony,” State v. Baird, 
    572 So. 2d 904
    , 906 (Fla. 1990), we conclude
    that, under the particular circumstances of this case, the instant limiting instruction
    was not effective to assuage the significant prejudice to the tobacco defendants of
    the jury’s hearing that Drs. Sinkovics and Altemose – neither of whom testified at
    trial – had diagnosed Mrs. Gloger with primary lung cancer.
    The origin of Mrs. Gloger’s cancer was the critical fact issue presented to
    the jury during phase 1 of the jury trial. The second amended complaint alleged
    that Mrs. Gloger’s cancer originated in her lungs, which, if true, would qualify her
    as a member of the class created in Engle v. Liggett Group, Inc., 
    945 So. 2d 1246
    (Fla. 2006).5 Whereas, the tobacco defendants maintained below that Mrs. Gloger
    5  Under Engle, an individual class member is entitled to certain factual findings
    against the tobacco defendants “as a matter of res judicata without need of further
    12
    was not an Engle class member because her cancer allegedly originated in her
    thymus gland, which is located in a region of the body between the lungs called the
    mediastinum.
    At trial, the lower court permissibly limited the number of experts per side
    so as to prevent the presentation of cumulative testimony. See Woodson v. Go,
    
    166 So. 3d 231
    , 234-35 (Fla. 5th DCA 2015). Dr. John Ruckdeschel, the third
    oncologist to treat Mrs. Gloger for her cancer after Drs. Sinkovics and Altemose,
    was identified by the estate as its causation expert and testified that Mrs. Gloger
    had died of cancer that originated in her lung, and that the lung cancer was caused
    proof.” R.J. Reynolds Tobacco Co. v. Schleider, 44 Fla. L. Weekly D82 (Fla. 3d
    DCA 2018). The factual findings include:
    (i) “that smoking cigarettes causes” certain named diseases including
    COPD and lung cancer; (ii) “that nicotine in cigarettes is addictive;”
    (iii) “that the [Engle] defendants placed cigarettes on the market that
    were defective and unreasonably dangerous;” (iv) “that the [Engle]
    defendants concealed or omitted material information not otherwise
    known or available knowing that the material was false or misleading
    or failed to disclose a material fact concerning the health effects or
    addictive nature of smoking cigarettes or both;” (v) “that the [Engle]
    defendants agreed to conceal or omit information regarding the health
    effects of cigarettes or their addictive nature with the intention that
    smokers and the public would rely on this information to their
    detriment;” (vi) “that all of the [Engle] defendants sold or supplied
    cigarettes that were defective;” (vii) “that all of the [Engle] defendants
    sold or supplied cigarettes that, at the time of sale or supply, did not
    conform to representations of fact made by said defendants;” and
    (viii) “that all of the [Engle] defendants were negligent.”
    Phillip Morris USA, Inc. v. Douglas, 
    110 So. 3d 419
    , 424-25 (Fla. 2013) (quoting
    
    Engle, 945 So. 2d at 1276-77
    ) (emphasis added).
    13
    by smoking. In contrast, the tobacco defendants relied upon the testimony of Dr.
    Kim Geisenger, a pathologist. Dr. Geisenger testified that Mrs. Gloger’s cancer
    originated in the thymus gland.
    The Florida Supreme Court has confirmed that an expert witness cannot
    testify on direct examination “that the expert relied on consultations with
    colleagues or other experts in forming his or her opinion.” Linn v. Fossum, 
    946 So. 2d 1032
    , 1033 (Fla. 2006). “[S]uch testimony is inadmissible because it
    impermissibly permits the testifying experts to bolster their opinions and creates
    the danger that the testifying experts will serve as conduits for the opinions of
    others who are not subject to cross-examination.” Id.; cf. Donshik v. Sherman, 
    861 So. 2d 53
    , 56 (Fla. 3d DCA 2003) (holding, in a medical malpractice action, that
    permitting the plaintiff to introduce a treatise “during the plaintiff’s case in chief
    served only to impermissibly bolster the credibility of the plaintiff’s experts and
    diminish the credibility of the defense expert’s opinions on the ultimate issue”).
    By permitting Mr. Gloger to testify that Drs. Sinkovics and Altemose had
    also diagnosed Mrs. Gloger with primary “lung cancer,” the trial court, albeit
    unwittingly, provided the estate the means of both (i) circumventing the court’s
    limitation on the presentation of cumulative expert testimony on the critical fact
    issue presented in phase 1 (the origin of Mrs. Gloger’s cancer), and (ii) bolstering
    the testimony of the estate’s expert, Dr. Ruckdeschel, with the opinions of two
    14
    colleagues who were not subject to cross-examination at trial. Indeed, immediately
    after soliciting the subject testimony from Mr. Gloger, the estate’s counsel
    emphasized the fact that all three of Mrs. Gloger’s treating oncologists had
    diagnosed her with primary lung cancer:
    Q. Did Dr. Ruckdeschel explain to you what he believed the –
    her diagnosis and its cause?
    A. Yes, he said she had lung cancer and he believed it was
    from smoking.
    Q. Obviously, this was tough news for you and your wife to
    hear?
    A. Yes, she was very weak at that point.
    Q. I’m talking about even going back to Dr. Sinkovics, I’m
    sorry. Going back to Dr. Sinkovics, back to 1995, the first time you
    heard it, the second time you heard it, the third time you heard it, or
    whenever you heard it.
    A. Oh, it was devastating. I – I had no idea. I mean, Irene
    was, for the most part, very healthy prior to this diagnosis.
    (Emphasis added).
    In this instance, we conclude that the trial court’s limiting instruction was
    ineffective in alleviating the significant danger that, on hearing the subject
    testimony from Mr. Gloger, the jury would conflate its primary charge of
    determining whether Mrs. Gloger died of primary lung cancer, with its
    concomitant duty of determining Mr. Gloger’s entitlement to damages for pain and
    suffering stemming therefrom.6 Cf. Diaz v. Fedex Freight East, Inc., 
    114 So. 3d 15
    224, 227 (Fla. 5th DCA 2012) (concluding that, where liability was at issue, a
    curative instruction was insufficient to overcome the prejudice created by improper
    testimony on causation).
    b. The trial court should have limited Mr. Gloger’s testimony as to the
    Glogers’s conversations with Drs. Sinkovics and Altemose
    “Section 90.403 may be applied to limit only a part of a statement or the
    details of an event or occurrence while admitting the basic statement or testimony.”
    Charles W. Ehrhardt, 1 Fla. Prac., Florida Evidence § 403.1 (May 2018). Though
    this principle is most commonly applied in the criminal arena, it is equally
    applicable in civil cases. See, e.g., Honeywell Intern., Inc. v. Guilder, 
    23 So. 3d 867
    , 870 (Fla. 3d DCA 2009) (concluding that the lower court erred in refusing to
    redact a portion of a letter introduced at trial because it was unfairly prejudicial
    under section 90.403); MCI Express, Inc. v. Ford Motor Co., 
    832 So. 2d 795
    , 801
    (Fla. 3d DCA 2002) (“Because the comment, ‘Goddamn Cubans,’ could easily
    have been rephrased without altering the meaning of the sentence, or detracting
    from its ostensible relevance, any probative value was outweighed by the prejudice
    that resulted from having the jury hear it.”).
    6 The confusing and misleading nature of the Glogers’s conversations with Drs.
    Sinkovics and Altemose is highlighted by the trial court’s pre-trial suggestion that
    defense counsel simply argue to the jury that the “doctor that told [Mr. Gloger]
    that [Mrs. Gloger had lung cancer] was wrong.” See, Section 
    I., supra
    .
    16
    In this case, the tobacco defendants claim that the trial court could have
    eliminated the substantial prejudice to the tobacco defendants under a section
    90.403 analysis by having Mr. Gloger – when testifying as to his conversations
    with Drs. Sinkovics and Altemose – simply rephrase the term “lung cancer” to
    “cancer,” “terminal cancer,” “deadly cancer,” or “however the Court finds is fair
    and appropriate under the circumstances.” We agree. As in MCI Express, Inc.,
    rephrasing the subject testimony in such a manner would not have altered the
    jury’s understanding of the testimony; nor would it have diminished the relevance
    for which it was offered at trial (i.e., establishing the emotional impact that hearing
    it had on Mr. 
    Gloger). 832 So. 2d at 801
    .
    Because the trial court had the discretion, under section 90.403, to decide
    how to limit Mr. Gloger’s testimony, we do not decide which iteration of “lung
    cancer” proposed by the tobacco defendants was appropriate in this case. Rather,
    we conclude that the trial court abused its discretion in not, in some fashion,
    limiting this testimony.
    c. The trial court’s failure to limit Mr. Gloger’s testimony was not harmless
    error
    A trial court’s error in the admission of evidence under section 90.403 is
    subject to harmless error analysis. See Special v. W. Boca Med. Ctr., 
    160 So. 3d 1251
    , 1256 (Fla. 2014). “To test for harmless error, the beneficiary of the error has
    the burden to prove that the error complained of did not contribute to the verdict.
    17
    Alternatively stated, the beneficiary of the error must prove that there is no
    reasonable possibility that the error contributed to the verdict.” 
    Id. Here, the
    origin of Irene Gloger’s cancer was of critical importance in this
    case as a jury finding that she had primary lung cancer would make her an Engle
    class member, thus, entitling her estate to the phase 1 common core findings in
    Engle. 
    Engle, 945 So. 2d at 1269
    . Moreover, Question 1 of the jury verdict form,
    as phrased, essentially provided that the estate could not prevail in this action
    unless the jury found that Mrs. Gloger had primary lung cancer:
    1. Was Irene Gloger addicted to cigarettes containing nicotine,
    and if so, was such addiction a legal cause of lung cancer and
    death?
    YES ____ NO _____
    If your answer to Question 1 was NO, please proceed no
    further except to sign and date this verdict form and return it to the
    courtroom. If your answer to Question 1 was YES, please proceed to
    Question 2.
    Given these circumstances, we cannot conclude that the error was harmless, i.e.,
    that there was no reasonable possibility that the error did not contribute to the
    substantial jury verdict entered in favor of the estate in this case.
    III.   CONCLUSION
    Because the subject out-of-court statements were not introduced to prove
    that Irene Gloger’s cancer originated in the lung, but to demonstrate the emotional
    impact on Mr. Gloger of hearing, for the first time, that his wife had cancer, the
    18
    statements were not hearsay. Such evidence was both relevant and material in this
    wrongful death action to support Mr. Gloger’s damages claim and was, therefore,
    admissible. Nevertheless, under the particular circumstances of this Engle progeny
    case, the out-of-court statements were subject to limitation under section 90.403
    because the limiting instruction given by the trial court did not effectively diminish
    the significant prejudice to the tobacco defendants of the jury’s hearing that Drs.
    Sinkovics and Altemose had diagnosed Mrs. Gloger with primary lung cancer
    caused by smoking cigarettes.
    We find that the trial court abused its discretion by failing to limit Mr.
    Gloger’s testimony (i.e., rephrasing the term “lung cancer”) in a manner that would
    eliminate the substantial prejudice to the tobacco defendants, without altering the
    jury’s understanding of the testimony or diminishing the relevance for which it was
    offered. This error was not harmless. Accordingly, we reverse the final judgment
    and remand for a new trial to be conducted consistent with this opinion.
    Reversed and remanded.
    19