08-001140N Douglas Stalley, As Guardian Of The Property Of Inaaya Limone vs. Florida Birth-Related Neurological Injury Compensation Association
 Status: Closed
DOAH Final Order on Wednesday, March 11, 2009.


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Summary: The infant`s brain injury likely post-dated "resuscitation in the immediate postdelivery period." Therefore, the claim was not compensable.

1STATE OF FLORIDA

4DIVISION OF ADMINISTRATIVE HEARINGS

8DOUGLAS STALLEY, AS GUARDIAN OF )

14THE PROPERTY OF INAAYA LIMONE, )

20)

21Petitioner, )

23)

24vs. ) Case No. 08-1140N

29)

30FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY )

35COMPENSATION ASSOCIATION, )

38)

39)

40Respondent, )

42)

43and )

45)

46FLORIDA HEALTH SCIENCES CENTER, )

51INC., d/b/a TAMPA GENERAL )

56HOSPITAL, )

58)

59Intervenor. )

61)

62FINAL ORDER

64Pursuant to notice, the Division of Administrative

71Hearings, by Administrative Law Judge William J. Kendrick, held

80a hearing in the above-styled case on November 13 and 14, 2008,

92by video teleconference, with sites in Tallahassee and Tampa,

101Florida.

102APPEARANCES

103For Petitioner: William E. Hahn, Esquire

109William E. Hahn, P.A.

113310 South Fielding Avenue

117Tampa, Florida 33606-2225

120For Respondent: Robert J. Grace, Jr., Esquire

127Stiles, Taylor & Grace, P.A.

132Post Office Box 460

136Tampa, Florida 33606

139For Intervenor: Edward J. Carbone, Esquire

145Patricia S. Calhoun, Esquire

149Buchanan Ingersoll, P.A.

1522500 Suntrust Financial Centre

156401 East Jackson Street

160Tampa, Florida 33602

163STATEMENT OF THE ISSUE

167At issue is whether Inaaya Limone, a minor, qualifies for

177coverage under the Florida Birth-Related Neurological Injury

184Compensation Plan (Plan).

187PRELIMINARY STATEMENT

189On March 5, 2008, Douglas Stalley, as Guardian Ad Litem for

200Inaaya Limone (Inaaya), a minor, filed a petition with the

210Division of Administrative Hearings (DOAH) to resolve whether

218Inaaya qualified for coverage under the Plan. The petition

227included the following allegations:

2319. The Petitioners do not believe that

238Inaaya Limone suffered a "birth-related

243neurological injury["] which was caused by

250oxygen deprivation or mechanical injury

255occurring in course of labor, delivery or

262resuscitation in the immediate post-delivery

267period at Tampa General Hospital. While

273Petitioners do believe that Inaaya Limone

279has suffered permanent mental and physical

285impairments, it is our firm belief that this

293was a consequence of the failure to properly

301staff and prepare for the extubation which

308took place on March 31, 2004, more than two

317full days following the birth of Inaaya

324Limone.

32510. Petitioners, in good faith, have filed

332this Petition as a direct consequence of an

340Order entered by the Honorable James M.

347Barton, Tampa[,] Florida, abating a civil

354action which has been brought against Tampa

361General Hospital . . . . [Emphasis in

369original]

370DOAH served the Florida Birth-Related Neurological Injury

377Compensation Association (NICA) with a copy of the claim on

387March 6, 2008, and on August 21, 2008, following a number of

399extensions of time within which to do so, NICA responded to the

411petition and gave notice that it was of the view the claim was

424compensable, and offered to provide benefits as prescribed by

433the Plan. In the interim, Florida Health Sciences Center, Inc.,

443d/b/a Tampa General Hospital, was accorded leave to intervene.

452Given that Petitioner was of the view that Inaaya did not

463suffer a "birth-related neurological injury," a hearing was

471scheduled for November 13 and 14, 2008, to resolve whether the

482claim was compensable. Left to resolve in a subsequent

491proceeding were issues related to an award. § 766.309(4), Fla.

501Stat.

502At hearing, Joint Exhibits 1A, 1B, and 2-15 were received

512into evidence, and Petitioner called Paul Gatewood, M.D.,

520Enid Gilbert-Barness, M.D., William Spellacy, M.D., and

527Michael Duchowny, M.D., as witnesses. No other witnesses were

536called, and no further exhibits were offered.

543The transcript of the hearing was filed November 26, 2008,

553and the parties were initially accorded 10 days from that date

564to file proposed orders. However, at Respondent's request the

573time for filing proposed orders was extended to December 16,

5832008. The parties elected to file such proposals and they have

594been duly-considered.

596FINDINGS OF FACT

599Stipulated facts

6011. Douglas Stalley is the Guardian Ad Litem for

610Inaaya Limone, a minor, and Fatima El-Atriss is Inaaya's mother.

620Inaaya was born a live infant on March 29, 2004, at Florida

632Health Sciences Center, Inc., d/b/a Tampa General Hospital, a

641licensed hospital located in Tampa, Florida, and her birth

650weight exceeded 2,500 grams.

6552. Obstetrical services were delivered at Inaaya's birth

663by William Spellacy, M.D., who, at all times material hereto,

673was a "participating physician" in the Florida Birth-Related

681Neurological Injury Compensation Plan as defined by Section

689766.302(7), Florida Statutes.

6923. The participating physician (Dr. Spellacy) and the

700hospital (Tampa General Hospital) complied with the notice

708provisions of the Plan.

7124. Inaaya sustained a brain injury caused by oxygen

721deprivation and was thereby rendered permanently and

728substantially mentally and physically impaired.

733Coverage under the Plan

7375. Pertinent to this case, coverage is afforded by the

747Plan for infants who suffer a "birth-related neurological

755injury," defined as an "injury to the brain . . . caused by

768oxygen deprivation . . . occurring in the course of labor,

779delivery, or resuscitation in the immediate postdelivery period

787in a hospital, which renders the infant permanently and

796substantially mentally and physically impaired." § 766.302(2),

803Fla. Stat. See also §§ 766.309 and 766.31, Fla. Stat.

8136. Here, it is undisputed that Inaaya suffered a brain

823injury, caused by oxygen deprivation, which rendered her

831permanently and substantially mentally and physically impaired.

838What must be resolved is whether the record supports the

848conclusion that, more likely than not, such injury occurred "in

858the course of labor, delivery, or resuscitation in the immediate

868postdelivery period" in the hospital, as required for coverage

877under the Plan. § 766.302(2), Fla. Stat.; Nagy v. Florida

887Birth-Related Neurological Injury Compensation Association , 813

893So. 2d 155, 160 (Fla. 4th DCA 2002)("According to the plain

905meaning of the words as written, the oxygen deprivation or

915mechanical injury to the brain must take place during labor, or

926delivery, or immediately afterward."). As to that issue,

935Petitioner was of the view that Inaaya's brain injury was not

946birth-related (did not result from oxygen deprivation that

954occurred during labor, delivery, or resuscitation in the

962immediate postdelivery period), but followed Inaaya's extubation

969on March 31, 2004, when she stopped breathing, and efforts to

980re-intubate her were not successful for 7 to 8 minutes. In

991contrast, NICA was of the view that Inaaya's brain injury likely

1002resulted from oxygen deprivation that occurred during labor,

1010delivery, or resuscitation immediately thereafter. Intervenor

1016agreed with NICA's position, and further contended that the

1025oxygen deprivation caused Innaya to aspirate meconium, which

1033lead to meconium aspiration syndrome, with further injury to her

1043brain following delivery.

1046Inaaya's birth and immediate newborn course

10527. At or about 12:01 a.m., March 29, 2004, Fatima El-

1063Atriss, with an estimated delivery date of March 8, 2004, and

1074the fetus post-dates at 43 weeks' gestation by ultrasound (US),

1084presented to Tampa General Hospital complaining of the onset of

1094uterine contractions at 7:00 p.m., the previous evening. There,

1103physical examination revealed Ms. El Atriss to be morbidly obese

1113(5'5", 383 lbs.); external fetal monitoring (begun at

112112:11 a.m.) revealed an overall reassuring fetal heart rate in

1131the 160 beat per minute (BPM) range; and vaginal examination (at

114212:40 a.m.) revealed the cervix at 1 centimeter dilation,

1151effacement thick, and the fetus high.

11578. Ms. El-Atriss was admitted to labor and delivery at or

1168about 1:30 a.m., for induction of labor; was induced with

1178petocin; progressed to complete dilation by 2:07 p.m.; and at

11882:14 p.m., Inaaya was born by spontaneous vaginal delivery. In

1198the interim, at 7:50 a.m., Ms. El-Atriss' membranes were

1207artificially ruptured, with thick meconium noted, and the Labor

1216and Delivery Record documents recurrent moderate/severe variable

1223decelerations and prolonged decelerations. However, given

1229Ms. El-Atriss' obesity, at times monitoring was difficult. But,

1238as late as 1:40 p.m., the physicians' progress notes described

1248the fetal heart rate as overall reassuring.

12559. At delivery, Inaaya was described as pink and vigorous,

1265but with evidence of mild respiratory distress ("grunting") and

1276was provided blow-by oxygen for 1 minute and suctioned (by bulb

1287and catheter). Otherwise, Inaaya did not require resuscitation.

1295Apgar scores were good (8 and 9, at one and five minutes,

1307respectively). 1 Retractions were documented at 5 minutes of

1316life, with improvement at 15 minutes of life. (Joint Exhibit

13261A, Labor and Delivery Record, page 2).

133310. According to the medical records, Inaaya was

1341transferred to the newborn nursery at or about 2:25 p.m. (Joint

1352Exhibit 1A, Labor and Delivery Record, page 2). There,

1361admission examination was normal, except for skin (meconium

1369stained nails, skin and cord were noted), throat (secretions

1378were noted), and lungs (retractions, grunting, and tachypnea

1386were noted). Impression/Plan was noted as: (1) viable post-

1395term appropriate for gestational age female - routine care; (2)

1405tachypnea/respiratory distress (thick meconium) - required

1411blowby on delivery, now to keep oxygen saturation greater than

142190 percent, check chest x-ray. (Joint Exhibit 2, Newborn

1430History and Physical).

143311. Insofar as the record reveals, Inaaya did not require

1443intervention until 2:50 p.m., when her respiratory rate was

1452elevated at 84, her oxygen saturation level was low at 87, and

1464she was accorded blow-by oxygen. Thereafter, at 3:15 p.m.,

1473notwithstanding she was receiving blow-by oxygen, Inaaya's

1480respiratory rate was still elevated at 98, and her oxygen

1490saturations remained low at 81. (Joint Exhibit 2, Transition

1499Newborn Admission DataBase; Joint Exhibit 10, page 32).

1507Accordingly, Inaaya was immediately tranferred to the neonatal

1515intensive care unit (NICU) for further management.

152212. Upon arrival at NICU, the neonatalogist noted that

1531Inaaya was crying, pink, well-perfused, in mild to moderate

1540distress (tachypnea, grunting, and retracting), and on exam

1548breath sounds were described as coarse with rales bilaterally.

1557Neurological exam was described as "normal/nonfocal."

1563Assessment was full-term, appropriate for gestational age baby

1571girl with meconium aspiration syndrome. Respiration plan

1578included NCPAP (nasal continuous positive airway pressure),

1585chest x-ray (CXR), and arterial blood gases (ABGs).

1593Neurological plan noted "[no] issues."

159813. Following evaluation, Inaaya was placed on NCPAP, and

1607chest x-ray was obtained at 3:23 p.m., which showed marked

1617prominence of pulmonary vessels consistent with congestive heart

1625failure. However, an "emergency echocardiogram due to

1632[patient's] clinical deterioration to rule out congenital heart

1640disease," ordered at 4:56 p.m., showed normal intracardiac

1648anatomy, and revealed pulmonary hypertension with bi-directional

1655ductus. Initial arterial blood gases drawn at 4:07 p.m.,

1664indicated a pH of 7.43, PO 2 of 64, PCO 2 of 35, and a BE (base

1681excess) of 0, findings inconsistent with acidosis. (Joint

1689Exhibit 6, p. 15).

169314. At or about 6:15 p.m., with her respiratory status

1703deteriorating, Inaaya was sedated in preparation for intubation,

1711and at 6:40 p.m., she was intubated and placed on high frequency

1723oscillator ventilation (HFOV) until the early morning of

1731March 30, 2004, when she was switched to synchronized

1740intermittent mandatory ventilation (SIMV). In the interim, at

174811:00 p.m., March 29, 2004, Dopamine was added to Inaaya's

1758interventions to support her blood pressure, and when that

1767proved inadequate Dobutamine was added at 4:00 a.m., March 30,

17772004.

177815. At 3:10 p.m., March 31, 2004, Inaaya was extubated,

1788and immediately clamped down and became apnic, with bradycardia.

1797Code was initiated at 3:11 p.m., with chest compressions and

1807positive pressure ventilation (PPV), and four attempts were made

1816to re-intubate Inaaya, with the fourth attempt at 3:18 p.m.,

1826proving successful. Notably, during attempts to re-intubate

1833Inaaya copious secretions were visualized below the cords, and

1842they were suctioned following re-intubation. Following re-

1849intubation, Inaaya was placed on SIMV.

185516. According to the Code 19 Flow Sheet, from 3:11 p.m.,

1866when the code was called, through re-intubation at 3:18 p.m.,

"1876pulse ox[imeter] not reading," and saturations were noted as

1885zero. During the same period, heart rate was noted as 40 to 50

1898beats per minute. Thereafter, at 3:19 p.m., heart rate was

1908noted as 50, with saturations at 20 percent; at 3:20 p.m., heart

1920rate was noted as 51, with saturations at 80 percent; and at

19323:21 p.m., heart rate was noted at 117, with saturations at 77

1944percent. The Code ended at 3:25 p.m., and post-code heart rate

1955was documented as 210, with saturations at 99 percent.

196417. Of note, the last arterial blood gas before the Code

1975was called, was taken at 1:52 p.m., and indicated a pH of 7.39,

1988PO 2 of 83, PCO 2 of 37, and a BD (base deficit) of 2, which were

2005within the reference range. First arterial blood gas following

2014the Code, at 3:33 p.m., indicated a pH of 7.10, PO 2 of 205, PCO 2

2030of 72, and a BD of 8, which were all outside the reference

2043range, and consistent with metabolic acidosis. Arterial blood

2051gases were still abnormal at 4:16 p.m., but by 6:57 p.m., they

2063were within the reference range.

206818. Later on March 31, 2004, sedation (Versed and

2077Fentanyl) was decreased, and Inaaya was slowly weaned until

2086April 2, 2004, when Versed and Fentanyl were stopped. In the

2097interim, on April 1, 2004, the nurses note Inaaya's pupil

2107reaction as sluggish bilaterally. However, given Inaaya's

2114sedation, the reliability of such observation as clinical

2122evidence of neurologic injury is fairly debatable.

212919. On April 7, 2004, an MRI of the brain was done. The

2142radiologist's impression was "[a]bnormal basal ganglia signal

2149[symmetrically demonstrated bilaterally involving the globus

2155pallidus]. This may be seen with hypoxia or hypoperfusion."

2164Follow-up MRI was done on December 1, 2004, and reported by the

2176same radiologist, as follows:

2180CLINICAL INDICATION: Developmental delay.

2184Abnormal MRI of the brain 04/07/04 performed

2191at Tower Advanced MRI.

2195The previous examination was performed at a

2202time with the clinical history of hypoxic

2209event. April, 2004. Comparison is made.

2215* * *

2218IMPRESSION:

22191. SEQUELA ARE NOTED FROM HYPOXIC EVENT.

2226THE AREA OF THE BASAL GANGLIA PREVIOUSLY

2233NOTED AS ABNORMAL HAS EVOLVED INTO

2239ABNORMALLY DECREASED SIGNAL SUGGESTING THE

2244POSSIBILITY OF DYSTROPHIC CALCIFICATIONS....

2248Notably, while Inaaya's brain injury is consistent with a

2257hypoxic/ischemic event, it is not possible, based solely on the

2267MRIs, to time the onset of the injury ( i.e. , as birth-related or

2280as related to the Code event).

228620. A neurology consult was requested, and on April 9,

22962004, Inaaya was evaluated by Maria Gieron-Korthals, M.D., a

2305pediatric neurologist. Dr. Gieron-Korthals reported the results

2312of her evaluation, as follows:

2317REASON FOR CONSULTATION: Abnormal MRI and

2323poor sucking.

2325HISTORY OF PRESENT ILLNESS: This baby was

2332born on March 29th, so it is 12 days old by

2343normal vaginal delivery with meconium-

2348stained amniotic fluid and respiratory

2353distress, subsequently diagnosed with

2357meconium-aspiration syndrome . . . .

2363The baby was initially put on ventilator,

2370subsequently placed on CPAP and subsequently

2376on oxygen by a nasal cannula and now is on

2386room air. On day four of life, the infant

2395apparently coded and needed some pressors

2401for a couple of days. The present concern

2409is that the baby has a poor suck and does

2419not take a lot by mouth.

2425Regarding the feeding, the information I

2431gather is that the sucking ability is

2438inconsistent. At times the baby does suck

2445well, at some other time not. Nevertheless,

2452the baby is gaining weight and the feeding

2460is supplemented by NG. The MRI of the brain

2469was performed a couple of days ago and it

2478was abnormal showing bilateral basal ganglia

2484lesions ie decreased signal on diffusion-

2490weighted images of MRI. We reviewed the MRI

2498today.

2499PHYSICAL EXAMINATION: On physical

2503examination, the baby's behavior was

2508somewhat unusual. The baby had episodes of

2515very strong cry, inconsolable and then

2521suddenly would stop crying, become

2526motionless with eyes widely open and turned

2533down. This behavior occurred intermittently

2538throughout the entire period of evaluation.

2544The head was shaved for IV and all sutures

2553were somewhat overlapping anterior fontanel

2558can be covered with the tip of the fifth

2567finger. There was a swelling and redness of

2575the right lower eyelid more than the left.

2583The pupils seem equal and reactive to light

2591and eye's moved to doll's maneuver. The

2598facial expression was symmetrical and

2603movements were normal. The gag reflex,

2609however, is decreased and the sucking is

2616intermittent and not strong. The other

2622developmental reflexes, such as Moro, palmar

2628and plantar grasps were present, but rooting

2635was not elicited.

2638On motor system examination, even when the

2645baby was crying, there was a marked head lag

2654on pulling up to sitting position. The

2661posture of the rest of the body with flexion

2670at the elbows and knees was normal. In

2678ventral suspension, however, the head was

2684flexed and the back was curved, indicative

2691of mild hypotonia. Deep tendon reflexes

2697were about 1 biceps and patella and there

2705was no clonus at the ankle.

2711IMPRESSION: This is a 12 day-old baby with

2719meconium aspiration syndrome followed by an

2725episode during which the baby coded and with

2733abnormal MRI for basal ganglia involvement

2739which is most likely secondary to hypoxic

2746event that occurred during the above

2752episode. The baby's suck is indeed of

2759concern and so is the baby's behavior of

2767going from crying to motionless state. One

2774should consider the possibility of seizures

2780and the plan is to obtain one EEG today to

2790capture the episode of going from crying to

2798motionless state and determine whether or

2804not these are seizures . . . .

2812EEG was done and was interpreted as normal.

282021. On April 12, 2004, Inaaya was discharged from Tampa

2830General Hospital. The diagnoses at that time included:

28381) Meconium Aspiration Syndrome

28422) Hypotension, resolved

28453) Clinical Sepsis, resolved

28494) Respiratory distress syndrome with

2854tacypnea, resolved

28565) Poor po intake, resolved

2861Outpatient follow-up with pediatrics, neurology, and cardiology

2868was recommended.

287022. Currently, Inaaya presents with severe cerebral palsy,

2878with profound mental and physical disabilities, that

2885indisputably are related to the brain injury she suffered (to

2895the basal ganglia) because of oxygen deprivation. Left to

2904resolve is the likely timing of Inaaya's brain injury.

2913The statutory presumption

291623. When, as here, the proof demonstrates that the infant

2926suffered an injury to the brain caused by oxygen deprivation

2936that rendered her permanently and substantially mentally and

2944physically impaired, a rebuttable presumption arises that the

2952injury is a "birth-related neurological injury," as defined by

2961the Plan. § 766.309(1)(a), Fla. Stat. See also Orlando

2970Regional Healthcare System, Inc. v. Alexander , 909 So. 2d 582

2980(Fla. 5th DCA 2005). In this case, the presumptions is that

2991Inaaya's injury occurred "in the course of labor, delivery, or

3001resuscitation in the immediate postdelivery period in . . .

3011[the] hospital." Consequently, it must be resolved whether

3019there was credible evidence produced to support a contrary

3028conclusion and, if so, whether absent the aid of such

3038presumption the record demonstrates, more likely than not, that

3047Inaaya's injury "occurred in the course of labor, delivery, or

3057resuscitation in the immediate postdelivery period. 2 Here, there

3066should be no serious debate that credible evidence was produced

3076(through the medical records and the various experts and fact

3086witnesses who testified) to support a contrary conclusion.

3094The likely cause and timing of the brain injury that

3104rendered Inaaya profoundly, neurologically impaired

310924. To address the likely cause and timing of the brain

3120injury that rendered Inaaya profoundly, neurologically impaired,

3127the parties offered the medical records related to Ms. El-

3137Atriss' antepartal course, as well as those associated with

3146Inaaya's birth and subsequent development. Additionally, the

3153parties offered the testimony (by deposition or live) of many of

3164the health care providers who were involved with Ms. El-Atriss'

3174and Inaaya's care at Tampa General Hospital, including

3182William Spellacy, M.D., the participating physician who provided

3190obstetrical services at Inaaya's birth; Enid Gilbert-Barness,

3197M.D., a pediatric pathologist; Terri Ashmeade, M.D., a

3205neonatologist; Maria Gieron-Korthals, M.D., a pediatric

3211neurologist; and Edward Blum, III, a respiratory therapist.

3219Finally, between them, the parties offered the testimony (by

3228deposition or live) of eight experts retained by them to offer

3239opinions related to the likely cause and timing of Inaaya's

3249brain injury. Offered by Petitioner were Paul Gatewood, M.D.,

3258an obstetrician/gynecologist; Michael Duchowny, M.D., a

3264pediatric neurologist; William Rhine, M.D., a neonatologist; and

3272Elias Chalhub, M.D., a pediatric neurologist. Offered by

3280Respondent was Joseph Casadonte, M.D., a pediatric neurologist,

3288and offered by Intervenor were Barry Schifrin, M.D., an

3297obstetrician/gynecologist; Edwina Popek, M.D., a pediatric

3303pathologist; and Marcus Hermansen, M.D., a neonatologist.

331025. The medical records, as well as the testimony of the

3321various health care providers, have been thoroughly reviewed.

3329Having done so, it is apparent that Inaaya developed respiratory

3339dysfunction, caused by meconium aspiration in utero , induced by

3348the stresses of labor, that revealed itself following delivery

3357with evidence of grunting and retractions. However, the record

3366failed to demonstrate that, more likely than not, any oxygen

3376deprivation she may have suffered during labor, delivery, or

3385resuscitation in the immediate postdelivery period, as a result

3394of her respiratory dysfunction or otherwise, resulted in brain

3403injury. Rather, the likely cause of Inaaya's brain injury was

3413shown to be the oxygen deprivation she suffered during the Code

3424event.

342526. In so concluding, it is noted that, following delivery

3435at 2:14 p.m., March 29, 2004, Inaaya was described as pink and

3447vigorous, albeit with evidence of mild respiratory distress; she

3456required minimal resuscitation measures (blow-by oxygen for 1

3464minute and suctioning); her Apgar scores were good (8 and 9, at

3476one and five minutes, respectively); her initial arterial blood

3485gases at 4:07 p.m., did not reveal any acidosis; her

3495neurological evaluations before sedation at 6:40 p.m., were

3503normal; the first arterial blood gases following the Code event

3513of March 31, 2004, were consistent with metabolic acidosis;

3522there was evidence of neurologic dysfunction after, but not

3531before, sedation was stopped on April 2, 2004; and the MRI

3542results were consistent with an acute hypoxic ischemic event.

3551Given the proof, it is likely, as opined by the health care

3563providers offered by Petitioner, that the cause of Inaaya's

3572brain injury was the oxygen deprivation she suffered during the

3582Code event on March 31, 2004, and not any oxygen deprivation she

3594may have suffered during labor, delivery, or resuscitation in

3603the immediate postdelivery period in the hospital. 3

3611Consequently, Inaaya was not shown to have suffered a "birth-

3621related neurological injury" as defined by the Plan. §

3630766.302(2), Fla. Stat. See also Nagy v. Florida Birth-Related

3639Neurological Injury Compensation Association , 813 So. 2d 155,

3647160 (Fla. 4th DCA 2002)("According to the plain meaning of the

3659words as written, the oxygen deprivation or mechanical injury to

3669the brain must take place during labor, or delivery, or

3679immediately afterward.").

3682CONCLUSIONS OF LAW

368527. The Division of Administrative Hearings has

3692jurisdiction over the parties to, and the subject matter of,

3702these proceedings. § 766.301, et seq ., Fla. Stat.

371128. The Florida Birth-Related Neurological Injury

3717Compensation Plan was established by the Legislature "for the

3726purpose of providing compensation, irrespective of fault, for

3734birth-related neurological injury claims" relating to births

3741occurring on or after January 1, 1989. § 766.303(1), Fla. Stat.

375229. The injured "infant, her or his personal

3760representative, parents, dependents, and next of kin," may seek

3769compensation under the Plan by filing a claim for compensation

3779with the Division of Administrative Hearings within five years

3788and 766.313, Fla. Stat. The Florida Birth-Related Neurological

3796Injury Compensation Association, which administers the Plan, has

"380445 days from the date of service of a complete claim . . . in

3819which to file a response to the petition and to submit relevant

3831written information relating to the issue of whether the injury

3841is a birth-related neurological injury." § 766.305(3), Fla.

3849Stat.

385030. If NICA determines that the injury alleged in a claim

3861is a compensable birth-related neurological injury, it may award

3870compensation to the claimant, provided that the award is

3879approved by the administrative law judge to whom the claim has

3890been assigned. § 766.305(7), Fla. Stat. However, if a dispute

3900exists, as it does in the instant case, the dispute must be

3912resolved by the assigned administrative law judge in accordance

3921with the provisions of Chapter 120, Florida Statutes.

3929§§ 766.304, 766.309, and 766.31, Fla. Stat.

393631. In discharging this responsibility, the administrative

3943law judge must make the following determination based upon the

3953available evidence:

3955(a) Whether the injury claimed is a

3962birth-related neurological injury. If the

3967claimant has demonstrated, to the

3972satisfaction of the administrative law

3977judge, that the infant has sustained a brain

3985or spinal cord injury caused by oxygen

3992deprivation or mechanical injury and that

3998the infant was thereby rendered permanently

4004and substantially mentally and physically

4009impaired, a rebuttable presumption shall

4014arise that the injury is a birth-related

4021neurological injury as defined in s.

4027766.303(2).

4028(b) Whether obstetrical services were

4033delivered by a participating physician in

4039the course of labor, delivery, or

4045resuscitation in the immediate post-delivery

4050period in a hospital; or by a certified

4058nurse midwife in a teaching hospital

4064supervised by a participating physician in

4070the course of labor, delivery, or

4076resuscitation in the immediate post-delivery

4081period in a hospital.

4085§ 766.309(1), Fla. Stat. An award may be sustained only if the

4097administrative law judge concludes that the "infant has

4105sustained a birth-related neurological injury and that

4112obstetrical services were delivered by a participating physician

4120at birth." § 766.31(1), Fla. Stat.

412632. Pertinent to this case, "birth-related neurological

4133injury" is defined by Section 766.302(2), to mean:

4141injury to the brain or spinal cord of a live

4151infant weighing at least 2,500 grams for a

4160single gestation or, in the case of a

4168multiple gestation, a live infant weighing

4174at least 2,000 grams at birth caused by

4183oxygen deprivation or mechanical injury

4188occurring in the course of labor, delivery,

4195or resuscitation in the immediate

4200postdelivery period in a hospital, which

4206renders the infant permanently and

4211substantially mentally and physically

4215impaired. This definition shall apply to

4221live births only and shall not include

4228disability or death caused by genetic or

4235congenital abnormality.

423733. As the proponents of the issue, the burden rested on

4248Respondent and Intervenor to demonstrate that Inaaya suffered a

"4257birth-related neurological injury." See Balino v. Department

4264of Health and Rehabilitative Services , 348 So. 2d 349, 350 (Fla.

42751st DCA 1977)("[T]he burden of proof, apart from statute, is on

4287the party asserting the affirmative issue before an

4295administrative tribunal."); Galen of Florida, Inc. v. Braniff ,

4304696 So. 2d 308, 311 (Fla. 1997)("[T]he assertion of NICA

4315exclusivity is an affirmative defense."); Tabb v. Florida Birth-

4325Related Neurological Injury Compensation Association , 880 So. 2d

43331253, 1260 (Fla. 1st DCA 2004)("As the proponent of the issue,

4345the burden rested on the health care providers to demonstrate,

4355more likely than not, that the notice provisions of the Plan

4366were satisfied.").

436934. Here, the proof failed to demonstrate that Inaaya's

4378impairments were, more likely than not, caused by an "injury to

4389the brain or spinal cord . . . caused by oxygen deprivation or

4402mechanical injury occurring in the course of labor, delivery, or

4412resuscitation in the immediate postdelivery period in a

4420hospital." Indeed, the more compelling proof established that

4428the cause of Inaaya's neurologic impairments was most likely a

4438brain injury caused by oxygen deprivation that post-dated labor,

4447delivery, and resuscitation in the immediate postdelivery

4454period. Consequently, given the provisions of Section

4461766.302(2), Florida Statutes, Inaaya does not qualify for

4469coverage under the Plan. See also Humana of Florida, Inc. v.

4480McKaughan , 652 So. 2d 852, 859 (Fla. 2d DCA 1995)("[B]ecause the

4492Plan . . . is a statutory substitute for common law rights and

4505liabilities, it should be strictly construed to include only

4514those subjects clearly embraced within its terms."), approved ,

4523Florida Birth-Related Neurological Injury Compensation

4528Association v. McKaughan , 668 So. 2d 974, 979 (Fla. 1996).

453835. Where, as here, the administrative law judge

4546determines that ". . . the injury alleged is not a birth-related

4558neurological injury . . . he [is required to] enter an order [to

4571such effect] and . . . cause a copy of such order to be sent

4586immediately to the parties by registered or certified mail."

4595§ 766.309(2), Fla. Stat. Such an order constitutes final agency

4605action subject to appellate court review. § 766.311(1), Fla.

4614Stat.

4615CONCLUSION

4616Based on the foregoing Findings of Fact and Conclusions of

4626Law, it is

4629ORDERED that the claim for compensation filed by

4637Douglas Stalley, as Guardian Ad Litem for Inaaya Limone, a

4647minor, is dismissed with prejudice.

4652DONE AND ORDERED this 11th day of March, 2009, in

4662Tallahassee, Leon County, Florida.

4666WILLIAM J. KENDRICK

4669Administrative Law Judge

4672Division of Administrative Hearings

4676The DeSoto Building

46791230 Apalachee Parkway

4682Tallahassee, Florida 32399-3060

4685(850) 488-9675

4687Fax Filing (850) 921-6847

4691www.doah.state.fl.us

4692Filed with the Clerk of the

4698Division of Administrative Hearings

4702this 11th day of March, 2009.

4708ENDNOTES

47091/ An Apgar score is a numerical expression of the condition of

4721a newborn infant, and reflects the sum points gained on

4731assessment of heart rate, respiratory effort, muscle tone,

4739reflex irritability, and color, with each category being

4747assigned a score ranging from the lowest score of 0 to a maximum

4760of 2. (Dorland's Illustrated Medical Dictionary, 28th Edition,

47681994; Joint Exhibit 1A, Labor and Delivery Record). Here, at

4778one minute, Inaaya's Apgar score totaled 8, with heart rate,

4788respiratory effort, and reflex irritability being graded at 2

4797each, and muscle tone and color being graded at 1 each. At five

4810minutes, Inaaya's Apgar score totaled 9, with heart rate,

4819respiratory effort, muscle tone, and reflex irritability being

4827graded at 2 each, and color being graded at 1.

48372/ Where, as here, a presumption is "established primarily to

4847facilitate the determination of a particular action in which the

4857presumption is applied, rather than to implement public policy,

4866[it] is a presumption affecting the burden of producing

4875evidence." § 90.303, Fla. Stat. The nature and effect or

4885usefulness of such a presumption in assessing the quality of the

4896proof was addressed in Berwick v. Prudential Property and

4905Casualty Insurance, Co. , 436 So. 2d 239, 240 (Fla. 3d DCA 1983),

4917as follows:

4919Unless otherwise provided by statute, a

4925presumption established primarily to

4929facilitate the determination of an action,

4935as here, rather than to implement public

4942policy is a rebuttable "presumption

4947affecting the burden of producing evidence,"

4953see § 90.303, Fla. Stat. (1981), a "bursting

4961bubble" presumption, see C. Ehrhardt, supra,

4967at §§ 302.1, 303.1. Such a presumption

4974requires the trier of fact to assume the

4982existence of the presumed fact unless

4988credible evidence sufficient to sustain a

4994finding of the non-existence of the presumed

5001fact is introduced, in which event the

5008bubble bursts and the existence of the fact

5016is determined without regard to the

5022presumption. See § 90.302(1), Fla. Stat.

5028(1981); C. Ehrhardt, supra, at § 302.1; see

5036generally Ladd, Presumptions in Civil

5041Actions, 1977 Ariz.St.L.J. 275 (1977)

5046Accord Caldwell v. Division of Retirement , 372 So. 2d 438 (Fla.

50571979), Public Health Trust of Dade County v. Valcin , 507 So. 2d

5069596 (Fla. 1987), and Insurance Company of the State of

5079Pennsylvania v. Estate of Guzman , 421 So. 2d 597 (Fla. 4th DCA

50911982. See also Gulle v. Boggs , 174 So. 2d 26, 29 (Fla. 1965),

5104citing with approval Tyrrell v. Prudential Insurance Co. , 109

5113Vt. 6, 192 A. 184, 115 A.L.R. 392, wherein it was stated:

5125Presumptions disappear when facts appear;

5130and facts are deemed to appear when evidence

5138is introduced from which they may be found.

51463/ In enacting the Florida Birth-Related Neurological Injury

5154Compensation Plan, the Legislature expressed its intent, as

5162follows:

5163It is the intent of the Legislature to

5171provide compensation, on a no-fault basis,

5177for a limited class of catastrophic injuries

5184that result in unusually high costs for

5191custodial care and rehabilitation. This

5196plan shall apply only to birth-related

5202neurological injuries.

5204§ 766.302(2), Fla. Stat.

5208In defining "birth-related neurological injury," the Legislature

5215chose to limit coverage to brain injuries that occurred during

"5225labor, delivery, or resuscitation in the immediate postdelivery

5233period." § 766.302(2), Fla. Stat. However, the Legislature did

5242not define "resuscitation in the immediate postdelivery period."

5250When not defined, "the plain and ordinary meaning of words in a

5262statute can be ascertained by reference to a dictionary."

5271Seagrave v. State , 802 So. 2d 281, 286 (Fla. 2001).

"5281Resuscitate" is commonly understood to mean "[t]o return to

5290life or consciousness; revive." The American Heritage

5297Dictionary of the English Language, New College Edition, 1979.

5306Dorland's Illustrated Medical Dictionary, 28th Edition, 1994,

5313defines "resuscitation" as "the restoration to life or

5321consciousness of one apparently dead; it includes such measures

5330as artificial respiration and cardiac massage." "Immediate" is

5338commonly understood to mean "[n]ext in line or relation[;] . . .

5351[o]ccuring without delay[;] . . . [o]f or near the present

5363time[;] . . . [c]lose at hand; near." The American Heritage

5375Dictionary of the English Language, New College Edition, 1979.

5384Finally, "period" is commonly understood to mean "[a]n interval

5393of time characterized by the occurrence of certain conditions or

5403events." The American Heritage Dictionary of the English

5411Language, New College Edition, 1979.

5416Under the statutory scheme then, the brain injury must occur

5426during labor, delivery, or immediately thereafter. Nagy v.

5434Florida Birth-Related Neurological Injury Compensation

5439Association , 813 So. 2d 155, 160 (Fla. 4th DCA 2002)("According

5450to the plain meaning of the words as written, the oxygen

5461deprivation or mechanical injury to the brain must take place

5471during labor, or delivery, or immediately afterward."). Such

5480conclusion is also consistent with "the requirement that

5488statutes which are in derogation of the common law be strictly

5499construed and narrowly applied." Nagy , 813 So. 2d at 159;

5509Humana of Florida, Inc. v. McKaughn , 652 So. 2d 852, 859 (Fla.

55212d DCA 1995)("[B]ecause the Plan . . . is a statutory substitute

5534for common law rights and liabilities, it should be strictly

5544construed to include only those subjects clearly embraced within

5553its terms."), approved , Florida Birth-Related Neurological

5560Injury Compensation Association v. McKaughn , 668 So. 2d 974, 979

5570(Fla. 1996).

5572Under the facts of this case, resuscitation in the immediate

5582postdelivery period ended not later than the five-minute Apgar,

5591by which time Inaaya had been provided blow-by oxygen for 1

5602minute and suctioned. Thereafter, Inaaya required no further

5610respiratory support until after her transfer to the newborn

5619nursery, when at 2:50 p.m., she was again provided blow-by

5629oxygen. Inaaya's subsequent brain injury, post-dated her

"5636resuscitation in the immediate postdelivery period." (Joint

5643Exhibit 6, pp. 36-39, 43-46, 66 and 67). Compare , Orlando

5653Regional Health Care System, Inc. v. Florida Birth-Related

5661Neurological Injury Compensation Association , 33 Fla.L.Weekly

5667D2563 (Fla. 5th DCA 2008).

5672COPIES FURNISHED :

5675(Via Certified Mail)

5678Kenney Shipley, Executive Director

5682Florida Birth Related Neurological

5686Injury Compensation Association

56892360 Christopher Place, Suite 1

5694Tallahassee, Florida 32308

5697(Certified Mail No. 7099 3400 0010 4404 3664)

5705Edward J. Carbone, Esquire

5709Patricia S. Calhoun, Esquire

5713Buchanan Ingersoll, P.A.

57162500 Suntrust Financial Centre

5720401 East Jackson Street

5724Tampa, Florida 33602

5727(Certified Mail No. 7099 3400 0010 4404 3657)

5735Robert J. Grace, Jr., Esquire

5740Stiles, Taylor & Grace, P.A.

5745Post Office Box 460

5749Tampa, Florida 33606

5752(Certified Mail No. 7099 3400 0010 4404 3640)

5760William E. Hahn, Esquire

5764William E. Hahn, P.A.

5768310 South Fielding Avenue

5772Tampa, Florida 33606-2225

5775(Certified Mail No. 7099 3400 0010 4404 3633)

5783Charlene Willoughby, Director

5786Consumer Services Unit - Enforcement

5791Department of Health

57944052 Bald Cypress Way, Bin C-75

5800Tallahassee, Florida 32399-3275

5803(Certified Mail No. 7099 3400 0010 4404 3626)

5811William Spellacy, M.D.

5814University of South Florida

5818College of Medicine

582112901 Bruce B. Downs Boulevard, MDC 2

5828Tampa, Florida 33602

5831(Certified Mail No. 7099 3400 0010 4404 3619)

5839Tampa General Hospital

5842One Davis Boulevard

5845Tampa, Florida 33602

5848(Certified Mail No. 7099 3400 0010 4404 3602)

5856NOTICE OF RIGHT TO JUDICIAL REVIEW

5862A party who is adversely affected by this Final Order is entitled

5874to judicial review pursuant to Sections 120.68 and 766.311,

5883Florida Statutes. Review proceedings are governed by the Florida

5892Rules of Appellate Procedure. Such proceedings are commenced by

5901filing the original of a notice of appeal with the Agency Clerk

5913of the Division of Administrative Hearings and a copy,

5922accompanied by filing fees prescribed by law, with the

5931appropriate District Court of Appeal. See Section 766.311,

5939Florida Statutes, and Florida Birth-Related Neurological Injury

5946Compensation Association v. Carreras , 598 So. 2d 299 (Fla. 1st

5956DCA 1992). The notice of appeal must be filed within 30 days of

5969rendition of the order to be reviewed.

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Date
Proceedings
PDF:
Date: 05/17/2012
Proceedings: Opinion (Per Curiam Affirmed) filed.
PDF:
Date: 05/17/2012
Proceedings: Mandate filed.
PDF:
Date: 02/10/2010
Proceedings: Appelant's Notice of Change of Status to Cited Authority filed.
PDF:
Date: 07/08/2009
Proceedings: Index, Record, and Certificate of Record sent to the Second District Court of Appeal.
PDF:
Date: 06/03/2009
Proceedings: Supplemental Index (of the Record) sent to the parties of record.
PDF:
Date: 05/15/2009
Proceedings: Invoice for the record on appeal mailed.
PDF:
Date: 05/15/2009
Proceedings: Index (of the Record) sent to the parties of record.
PDF:
Date: 04/03/2009
Proceedings: Notice of Appeal filed and Certified copy sent to the Second District Court of Appeal this date.
PDF:
Date: 03/17/2009
Proceedings: Certified Return Receipt received this date from the U.S. Postal Service.
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Date: 03/16/2009
Proceedings: Certified Return Receipt received this date from the U.S. Postal Service.
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Date: 03/13/2009
Proceedings: Certified Return Receipt received this date from the U.S. Postal Service.
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Date: 03/13/2009
Proceedings: Certified Return Receipt received this date from the U.S. Postal Service.
PDF:
Date: 03/11/2009
Proceedings: DOAH Final Order
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Date: 03/11/2009
Proceedings: Certified Mail Receipts stamped this date by the U.S. Postal Service.
PDF:
Date: 03/11/2009
Proceedings: Final Order (hearing held November 13 and 14, 2008). CASE CLOSED.
PDF:
Date: 02/25/2009
Proceedings: Letter to parties of record from Judge Kendrick acknowledging receipt of your legal assistant`s letter of February 19, 2009, with enclosures.
Date: 02/19/2009
Proceedings: Letter to Judge Kendrick from H. O`Brien enclosing MRI reports of I. Limone filed (not available for viewing).
PDF:
Date: 02/19/2009
Proceedings: Letter to parties of record from Judge Kendrick regarding the reports for inclusion in the record.
PDF:
Date: 01/26/2009
Proceedings: Letter to parties of record from Judge Kendrick acknowledging receipt of your letter of January 15, 2009.
PDF:
Date: 01/21/2009
Proceedings: Letter to Judge Kendrick from W. Hahn regarding Mr. Graces` non-objection to the page and line designation of Dr. Ashmead and Mr. Blum filed.
Date: 01/06/2009
Proceedings: Joint Exhibits 1A, 1B, 2-15 and Medical Records filed (not available for viewing).
PDF:
Date: 01/06/2009
Proceedings: Letter to parties of record from Judge Kendrick acknowledging receipt of the Joint Exhibits (1A, 1B, ad 2-15).
PDF:
Date: 12/17/2008
Proceedings: Intervenor`s Proposed Final Order filed.
PDF:
Date: 12/17/2008
Proceedings: Intervenor`s Notice of Filing Propsed Recommended Order filed.
PDF:
Date: 12/16/2008
Proceedings: Respondent`s Proposed Final Order on Compensability filed.
PDF:
Date: 12/16/2008
Proceedings: Petitioner`s Notice of Filing Proposed Final Order (with corrected Certificate of Service).
PDF:
Date: 12/16/2008
Proceedings: (Petitioner`s Proposed) Opinion Final Order filed.
PDF:
Date: 12/16/2008
Proceedings: Petitioner`s Notice of Filing Proposed Order filed.
PDF:
Date: 12/16/2008
Proceedings: Opinion: (Proposed) Final Order filed.
PDF:
Date: 12/04/2008
Proceedings: Order (Motion for Extension of Time in which to File Proposed Orders is grantes, parties are accorded until December 16, 2008, to file proposed orders).
PDF:
Date: 12/03/2008
Proceedings: Motion for Extension of Time in which to File Proposed Orders filed.
Date: 11/26/2008
Proceedings: Transcript filed (not available for viewing).
PDF:
Date: 11/26/2008
Proceedings: Notice of Filing (Transcript) filed.
PDF:
Date: 11/25/2008
Proceedings: Letter to Judge Kendrick from R. Grace enclosing Joint Exhibits (exhibits not available for viewing) filed.
PDF:
Date: 11/17/2008
Proceedings: Notice of Withdrawal of Expert Witness filed.
PDF:
Date: 11/17/2008
Proceedings: (Proposed) Order on Pending Motions filed.
PDF:
Date: 11/14/2008
Proceedings: Petitioner`s Response to Intervenor Florida Health Sciences Center, Inc., d/b/a Tampa General Hospital`s Motion to Strike Witnesses or Alternative Motion for Enlargement of Time filed.
Date: 11/13/2008
Proceedings: CASE STATUS: Hearing Held.
PDF:
Date: 11/12/2008
Proceedings: (Proposed) Order on Pending Motions filed.
PDF:
Date: 11/12/2008
Proceedings: Order (denying Intervenor`s Motion to Strike Witnesses or Alternatively Motion for Enlargement of Time).
Date: 11/10/2008
Proceedings: CASE STATUS: Motion Hearing Held.
PDF:
Date: 11/10/2008
Proceedings: Intervenor Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital`s Motion to Strike Witnesses or Alternative Motion for Enlargement of Time filed.
PDF:
Date: 11/10/2008
Proceedings: Intervenor`s Pre-hearing Stipulation filed.
PDF:
Date: 11/10/2008
Proceedings: Petitioner Response to Intervenor Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital`s Motion to Strike Witnesses or Alternative Motion for Enlargement of Time filed.
PDF:
Date: 11/07/2008
Proceedings: Letter to Judge Kendrick from W. Hahn in response to Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital`s Motion to Strike Witnesses or Alternative Motion for Enlargement of Time filed.
PDF:
Date: 11/06/2008
Proceedings: Intervenor Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital`s Motion to Strike Witnesses or Alternative Motion for Enlargement of Time filed.
PDF:
Date: 11/05/2008
Proceedings: Pre-hearing Stipulation filed.
PDF:
Date: 11/05/2008
Proceedings: Petitioner Supplemental Answers to Defendant Neurological Injury Compensation Association Expert Interrogatories filed.
PDF:
Date: 11/03/2008
Proceedings: Notice of Video Deposition of Barry S. Schifrin, M.D. filed.
PDF:
Date: 11/03/2008
Proceedings: Notice of Video Deposition of Edwina J. Popek, M.D. filed.
PDF:
Date: 11/03/2008
Proceedings: Notice of Video Deposition of Marcus Hermansen, M.D. filed.
PDF:
Date: 11/03/2008
Proceedings: Notice of Video Deposition of Gordon SZE, M.D. filed.
PDF:
Date: 11/03/2008
Proceedings: Notice of Taking Videotaped Deposition Duces Tecum via Videoconference for Use at NICA Hearing on November 13 and 14, 2008 filed.
PDF:
Date: 11/03/2008
Proceedings: Respondent, Florida Birth-related Neurological Injury Compensation Association`s, Amended Notice of Taking Deposition Duces Tecum filed.
PDF:
Date: 10/31/2008
Proceedings: Subpoena Ad Testificandum (W. Spellacy) filed.
PDF:
Date: 10/31/2008
Proceedings: Respondent, Florida Birth-Related Neurological Injury Compensation`s Notice of Taking Deposition Duces Tecum filed.
PDF:
Date: 10/30/2008
Proceedings: Defendant Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital`s Univerified Answers to Petitioner`s Expert Interrogatories filed.
PDF:
Date: 10/30/2008
Proceedings: Notice of Taking Videotaped Deposition for Use at NICA Hearing on November 12 and 14, 2008 (E. Chalhub) filed.
PDF:
Date: 10/29/2008
Proceedings: Respondent, Florida Birth-related Neurological Injury Compensation Association`s, Notice of Filing Unexecuted Answers to Expert Interrogatories of Petitioner filed.
PDF:
Date: 09/29/2008
Proceedings: Petitioner Answers to Defendant Neurological Injury Compensation Association Expert Interrogatories filed.
PDF:
Date: 09/29/2008
Proceedings: Petitioner Interrogatories to Defendant Florida Health Sciences Center filed.
PDF:
Date: 09/29/2008
Proceedings: Petitioner Interrogatories to Defendant Neurological Injury Compensation Association filed.
PDF:
Date: 08/28/2008
Proceedings: Notice of Appearance (filed by R. Grace).
PDF:
Date: 08/21/2008
Proceedings: Notice of Filing (Medical Evaluation from J. Casadonte) filed.
PDF:
Date: 08/20/2008
Proceedings: Order of Pre-hearing Instructions.
PDF:
Date: 08/20/2008
Proceedings: Notice of Hearing by Video Teleconference (hearing set for November 13 and 14, 2008; 9:00 a.m.; Tampa and Tallahassee, FL).
PDF:
Date: 07/31/2008
Proceedings: Order Granting Extension of Time (response to the petition to be filed by August 15, 2008).
PDF:
Date: 07/31/2008
Proceedings: Notice of Unavailability filed.
PDF:
Date: 07/30/2008
Proceedings: Motion for Extension of Time in which to Respond to Petition filed.
PDF:
Date: 06/02/2008
Proceedings: Order Granting Extension of Time (response to the petition to be filed by July 30, 2008).
PDF:
Date: 05/30/2008
Proceedings: Motion for Extension of Time in Which to Respond to Petition filed.
PDF:
Date: 05/06/2008
Proceedings: Order Granting Extension of Time (response to the petition to be filed by May 30, 2008).
PDF:
Date: 05/01/2008
Proceedings: Response of Petitioner to Motion to Extend Time filed.
PDF:
Date: 04/24/2008
Proceedings: Motion for Extension of Time in Which to Respond to Petition filed.
PDF:
Date: 04/10/2008
Proceedings: Order (Florida Health Sciences Center, Inc., d/b/a Tampa General Hospital is granted Intervenor status).
PDF:
Date: 04/09/2008
Proceedings: Response to Motion to Act as Qualified Representative filed.
PDF:
Date: 04/09/2008
Proceedings: Response to Motion to Intervene filed.
PDF:
Date: 04/07/2008
Proceedings: Order (Motion to accept K. Shipley as qualified representative granted).
PDF:
Date: 04/02/2008
Proceedings: Motion to Intervene Filed by Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital filed.
PDF:
Date: 03/31/2008
Proceedings: Motion to Intervene filed by Florida Health Sciences Center, Inc., d/b/a Tampa General Hospital filed.
PDF:
Date: 03/24/2008
Proceedings: Motion to Act as a Qualified Representative Before the Division of Administrative Hearings filed.
PDF:
Date: 03/13/2008
Proceedings: Certified Return Receipt received this date from the U.S. Postal Service.
PDF:
Date: 03/10/2008
Proceedings: Certified Return Receipt received this date from the U.S. Postal Service.
PDF:
Date: 03/06/2008
Proceedings: Certified Mail Receipts stamped this date by the U.S. Postal Service.
PDF:
Date: 03/06/2008
Proceedings: Letter to Kenney Shipley from Claudia Llado enclosing NICA claim for compensation.
PDF:
Date: 03/06/2008
Proceedings: Notice sent out that this case is now before the Division of Administrative Hearings.
Date: 03/05/2008
Proceedings: NICA filing fee (Check No. 1052; $15.00) filed (not available for viewing).
PDF:
Date: 03/05/2008
Proceedings: Defendant, Florida Health Sciences Center, Inc.`s, Answer and Affirmative Defenses filed.
PDF:
Date: 03/05/2008
Proceedings: Order Appointing Guardian of Property of Minor filed.
PDF:
Date: 03/05/2008
Proceedings: Letter of Guardianship of the Property of Minor filed.
PDF:
Date: 03/05/2008
Proceedings: Complaint filed.
PDF:
Date: 03/05/2008
Proceedings: Order Granting Defendant`s Motion to Abate filed.
PDF:
Date: 03/05/2008
Proceedings: Affidavit of Paul Gatewood, M.D. filed.
PDF:
Date: 03/05/2008
Proceedings: Affadivit of William Rhine, M.D. filed.
PDF:
Date: 03/05/2008
Proceedings: Affidavit of Elias Chalhub, M.D. filed.
PDF:
Date: 03/05/2008
Proceedings: Petition Pursuant to Florida Statute Section 766.301 et seq. filed.
PDF:
Date: 03/05/2008
Proceedings: Referral Letter filed.

Case Information

Judge:
WILLIAM J. KENDRICK
Date Filed:
03/05/2008
Last Docket Entry:
05/17/2012
Location:
Tampa, Florida
District:
Middle
Agency:
Florida Birth-Related Neurological Injury Compensation Associati
Suffix:
N
 

Counsels

Related DOAH Cases(s) (1):

Related Florida Statute(s) (15):