Hezekiah Walters was a 14-year-old eager to play football at Middleton High School in Tampa. He had no known heart issues when he collapsed during summer conditioning drills in June 2019. Minutes into the workout, he suffered cardiac arrest and died—his death was later linked to undiagnosed heart conditions and heat-related complications.

Now, Florida has become the first state in the nation to require heart screenings for all high school athletes, a response driven by tragedies like Walters’ and growing concerns that traditional sports physicals miss life-threatening cardiac issues in teens.

The “Second Chance Act,” which took effect July 1, mandates that student-athletes complete at least one electrocardiogram (EKG) before competing on school teams. While the requirement doesn’t take full effect until the 2026-27 school year, EKG results obtained within two years of that deadline will be accepted.

The legislation follows years of advocacy by parents and health experts who say standard pre-participation exams are inadequate. Research shows typical physicals and family history checks detect only 10% to 20% of dangerous heart conditions, whereas including an EKG can boost detection to over 90%, according to Parent Heart Watch.

“This is long overdue,” said Shawn Sima, a retired Air Force physician’s assistant and an advocate with the nonprofit Who We Play For. His own daughter survived sudden cardiac arrest at 16, despite having passed every school-required physical. Her condition went undiagnosed for years.

“I still can’t believe how many kids are walking around with deadly heart conditions and no one knows until it’s too late,” Sima told WEAR-TV.

In Walters’ case, an autopsy showed he died from exertional hyperthermia—dangerously high core body temperature—alongside cardiac hypertrophy, a thickening of the heart muscle. An investigation found that Middleton High School lacked proper documentation for him, including his physical and required safety training forms. Hillsborough County Public Schools later paid Walters’ family nearly $1 million and adopted new safety protocols in his name.

Sudden cardiac arrest is the leading cause of death among student-athletes, and Parent Heart Watch estimates that 1 in 300 young athletes unknowingly have a condition that puts them at risk.

In some parts of Florida, EKG screenings have already saved lives. When Etta Gibson’s son James, a healthy football player at Titusville High, got an EKG “just to pass the time,” the results revealed he had hypertrophic cardiomyopathy—the same condition that killed young athlete Rafe Maccarone. Gibson credits Who We Play For with saving her son’s life.

Several counties—including Orange, Seminole, Osceola, Volusia, and Flagler—had already implemented local EKG screening policies before the new state law. Brevard County offers an opt-out provision. Flagler joined in after 18-year-old Chance Gainer collapsed and died during a football game in Port St. Joe.

The law requires high schools to provide low-cost EKGs for grades 9 through 12, with opt-out options for medical or religious reasons or when screenings can’t be provided for $50 or less. The Florida High School Athletic Association has until the 2028-29 school year to implement rules barring athletes with abnormal EKG results from playing until they receive medical clearance.

The measure also requires schools to have automated external defibrillators (AEDs) on campus and to train staff on how to respond to diabetic and severe allergic emergencies.

States like Texas, Pennsylvania, and Tennessee have passed laws requiring schools to educate families about sudden cardiac arrest, but none have mandated screenings. Florida’s move is being closely watched as a possible national model.

“This could be one of the most life-saving bills ever passed here,” Sima said.

Martha Lopez-Anderson, executive director of Parent Heart Watch, called it a milestone: “Thanks to the tireless work of families, foundations, and health professionals, Florida has raised the standard of care for young athletes nationwide.”

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