11-004075CB In Re: Senate Bill 6 (Denise Gordon Brown And David Brown) vs. *
 Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, March 30, 2012.


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1THE FLORIDA SENATE

4SPECIAL MASTER ON CLAIM BILLS

9Location

10402 Senate Office Building

14Mailing Address

16404 South Monroe Street

20Tallahassee, Florida 32399 - 1100

25(850) 487 - 5237

29DATE COMM ACTION

321 2/1/11 SM Favorable

36December 1, 2011

39The Honorable Mike Haridopolos

43President, The Florida Senate

47Suite 409, The Capitol

51Tallahassee, Florida 32399 - 1100

56Re: SB 6 (2012) Î Senator Joe Negron

64Relief of Denise Brown and David Brown, for the benefit of their son,

77Darian Brown

79SPECIAL MASTERÓS FINAL REPORT

83THIS UNOPPOSED EQUITABLE CLAIM AGAINST THE

89NORTH BROWARD HOSPIT AL DISTRICT, WHICH I S FOR

98$2 MILLION IN LOCAL FUNDS, ARISES FROM T HE BIRTH

108OF DARIAN BROWN, A C HILD WHO SUFFERED A

117CATASTROPHIC BRAIN I NJURY IN UTERO DUE T O THE

127HOSPITAL STAFF'S NEG LIGENT DELAY IN

133R ECOGNIZING THE SIGNS OF FETAL DISTRESS,

140WHICH RESULTED IN AN UNTIMELY DELIVERY BY C -

149SECTION.

150FINDINGS OF FACT: On January 10, 2000, Denise Brown's obstetrician, Dr.

161Danoff, discovered that the fetal heart rate of the baby Mrs.

172Brown was carrying was elev ated. Because Mrs. Brown,

181who was then about 33 weeks pregnant, had delivered

190prematurely in the past, Dr. Danoff sent her to Broward

200General Hospital for observation and to rule out preterm

209labor. Mrs. Brown was admitted to the hospital at 11:30 a.m.

220D r. Danoff directed that Mrs. Brown have continuous fetal

230heart monitoring and gave standing orders that the nurse on

240duty was to notify the obstetrician if the baby's heart rate

251ever exceeded 160 beats per minute.

257SPECIAL MASTERÓS FINAL REPORT Î SB 6 (2012)

265December 1, 2011

268Page 2

270From January 10 through January 14, 2000 , Mrs. Brown

279remained stable, and her baby's heart rate stayed within

288normal limits. At about 5:00 p.m. on January 14, 2000,

298however, the fetal monitoring strips (printed graph paper

306showing displaying "tracings" of both the fetal heart rate and

316uterine c ontractions) began disclosing an accelerated heart

324rate (a condition known as tachycardia). The nursing staff

333did not notify the obstetrician of this development, despite

342the standing order to do so.

348Over the next few hours, the fetal monitoring strips showed

358increasingly worrisome signs, namely consistent fetal

364tachycardia and loss of fetal heart rate variability. (A healthy

374fetal heart beats at varying rates, creating a tracing that

384looks like a jag ged line. Loss of fetal heart rate variability

396produces a smooth line.) Variability indicates fetal wellbeing.

404The absence of variability may indicate fetal distress. At

41311:00 p.m., the baby's heart rate started to slow periodically

423after uterine contr actions. When this occurs, it is called a

"434late deceleration." Late decelerations are an ominous sign,

442especially in conjunction with tachycardia and loss of

450variability. The nursing staff, however, did not notify the

459obstetrician, or any other physicia n, that Mrs. Brown's baby

469might be in trouble.

473The fetal tachycardia, loss of variability, and late

481decelerations continued throughout the night. At about 5:15

489a.m., the attending nurse finally called an obstetrician, Dr.

498Vasanti Puranik, who was an empl oyee of North Broward

508Hospital District. At Dr. Puranik's request, the fetal

516monitoring strips were faxed to her for review. Upon receipt,

526the doctor discovered that the graph paper had been fed into

537the electronic fetal monitor upside down. The strips,

545therefore, were not readily interpretable, although it could be

554seen that the baby's heart rate lacked variability.

562Dr. Puranik consulted by telephone with another obstetrician,

570Laurie Scott, M.D., and they agreed that it was time to

581deliver Mrs. Brown's baby. Neither doctor rushed to the

590hospital, however. Dr. Puranik arrived on the obstetrical unit

599at 6:27 a.m., where she ordered a routine Caesarian section.

609Mrs. Brown was prepared for surgery. Dr. Puranik began

618the C - section at 7:24 a.m., and Daria n was born at 7:27 a.m.

633SPECIAL MASTERÓS FINAL REPORT Î SB 6 (2012)

641December 1, 2011

644Page 3

646Darian had been oxygen - deprived in his mother's womb for

657hours before his birth. As a result, he was born with

668numerous complications, including respiratory distress

673syndrome, cystic kidney disease, neonatal jaundice,

679neonatal hy poglycemia, and newborn intraventricular

685hemorrhage. He required aggressive resuscitation.

690Eventually, Mrs. Brown and Darian were discharged from the

699hospital. The Browns were not told, however, that Darian

708might have suffered a serious brain injury.

715I n October 2000, Mrs. Brown became concerned that her

725son was not meeting developmental milestones. Her

732inquiries to the pediatrician resulted in a computed

740tomography (CT) scan of Darian's brain being ordered. The

749CT scan showed that Darian's brain had b een seriously and

760irreversibly damaged by partial prolonged hypoxia (oxygen

767deprivation) in the hours before his birth.

774The insult to Darian's brain has left him suffering from

784cerebral palsy, spastic quadriplegia, and developmental

790delay. He is unable t o talk but smiles at family members and

803communicates basic needs by gesturing (e.g., pointing to his

812stomach when hungry or to his head when he has a

823headache). Darian has no bladder or bowel control, cannot

832feed himself, and is unable to perform any acti vities of daily

844living. He will be totally dependent on others for care and

855treatment for the rest of his life.

862Paul M. Deutsch, Ph.D., performed a comprehensive

869evaluation of Darian and prepared Life Care Plan, which

878quantifies the future medical expenses that will be incurred

887over the course of Darian's lifetime. The report prepared by

897the plaintiffs' economist, Raffa Consulting Economists, Inc. ,

904which takes into account Dr. Deutsch's Life Care Plan,

913concludes that the present value of Daran's f uture medical

923needs is between $11.5 and $13.6 million, and that his

933estimated lost earning capacity, reduced to present value, is

942approximately $0.68 million.

945LEGAL PROCEEDINGS: In 2003, Mr. and Mrs. Brown brought suit on their son's

958behalf, and in the ir respective individual capacities, against

967the North Broward Hospital District and others. The action

976was filed in the Circuit Court in and for Broward County,

987Florida.

988SPECIAL MASTERÓS FINAL REPORT Î SB 6 (2012)

996December 1, 2011

999Page 4

1001While the lawsuit was pending, the Browns settled with Dr.

1011Scott and Parinatal As sociates, P. A. for a confidential

1021amount. The case proceeded to trial in 2008 against the

1031North Broward Hospital District as the sole remaining

1039defendant. On June 13, 2008, after four weeks of trial, the

1050jury rendered a verdict in favor of the plaintiff s and against

1062the district, awarding a total of $35.2 million in damages.

1072The resulting judgment was appealed. In June 2010, the

1081Florida Fourth District Court of Appeal affirmed.

1088The hospital district sued its insurers seeking a declaration

1097of coverage for the damages awarded to the Browns. The

1107coverage lawsuit led to a global settlement under which the

1117district's insurers paid the Browns $10.35 million, the district

1126paid its sovereign immunity limit of $200,000, and the parties

1137agreed that the plaintif fs could seek an additional $2 million

1148through an uncontested claim bill in that amount.

1156Under the settlement agreements, the plaintiffs' net recovery

1164to date (after satisfying medical and legal expenses and

1173attorneys' fees) is approximately $8.5 million. They have

1181paid roughly $3.3 million to their attorneys.

1188CLAIMANTS' ARGUMENTS: The North Broward Hospital District is vicariously liable for

1199the negligent acts of its employees and agents, including but

1209not limited to:

1212Failing timely to alert Mrs. Bro wn's obstetrician, or any

1222medical doctor, of the onset of fetal tachycardia, despite a

1232standing order to do just that.

1238Failing timely to notify a physician of the loss of fetal

1249heart rate variability and subsequent onset of late

1257decelerations, which (the nurses should have known)

1264indicated that the baby was likely in distress.

1272Failing to notice, for hours, that the graph paper in the

1283electronic fetal monitor had been inserted upside down,

1291producing tracings that were not readily interpretable.

1298Failing to order an emergency C - section immediately

1307upon discovery that the baby's fetal heart signals were non -

1318reassuring.

1319SPECIAL MASTERÓS FINAL REPORT Î SB 6 (2012)

1327December 1, 2011

1330Page 5

1332RESPONDENT'S POSITION: The North Broward Hospital District does not oppose the bill.

1344The Chief Executive Officer of the district has attes ted that if

1356the claim bill were enacted, the $2 million award would be

1367paid out of the district's general operating account, and that

1377the payment of this sum would not in any way detrimentally

1388impact the district's ability to provide medical services to th e

1399people of Broward County.

1403CONCLUSIONS OF LAW: As provided in section 768.28, Florida Statutes (2010),

1414sovereign immunity shields the North Broward Hospital

1421District against tort liability in excess of $200,000 per

1431occurrence. See Eldred v. North Browa rd Hospital District ,

1440498 So. 2d 911, 914 (Fla. 1986)(§ 768.28 applies to special

1451hospital taxing districts); Paushter v. South Broward Hospital

1459District , 664 So. 2d 1032, 1033 (Fla. 4th DCA 1995). Unless

1470a claim bill is enacted, therefore, Darian and his parents will

1481not realize the full benefit of the settlement agreement they

1491have made with the district.

1496Under the doctrine of respondeat superior, the North

1504Broward Hospital District is vicariously liable for the negligent

1513acts of its agents and employee s, when such acts are within

1525the course and scope of the agency or employment. See

1535Roessler v. Novak , 858 So. 2d 1158, 1161 (Fla. 2d DCA

15462003).

1547The nurses and obstetrician who were involved in Mrs.

1556Brown's treatment were employees of the district actin g

1565within the scope of their employment. Accordingly, the

1573negligence of these actors is attributable to the district.

1582The district's employee s each had a duty to provide Mrs.

1593Brown and Darian with competent medical care. Such duty

1602was breached, with tragic consequences: Had Darian been

1610delivered shortly after his fetal heart signals became

1618ominous late in the evening on January 14, 2000, as he

1629reasonably should have been, rather than 8 or 9 hours later,

1640as in fact he was, Darian likely would not have suffered a

1652catastrophic brain injury before birth. The negligence of the

1661district's employees and agents was a direct and proximate

1670cause of Darian's substantial damages.

1675The sum that the North Florida Hospital District has agreed

1685to pay Darian ($2.2 mi llion in the aggregate) is a relatively

1697small percentage of Darian's total economic losses. If this

1706SPECIAL MASTERÓS FINAL REPORT Î SB 6 (2012)

1714December 1, 2011

1717Page 6

1719claim bill is enacted, the Brown family's recovery, including

1728the funds previously received from other sources, should be

1737adequate to cover Darian's future medical needs. The

1745undersigned concludes that the settlement at hand is both

1754reasonable and responsible.

1757ATTORNEY Ó S FEES: Section 768.28(8), Florida Statutes, provides that "[n] o

1769attorney may charge, demand, receive, or collect, for

1777services rendered, fees in excess of 25 percent of any

1787judgment or settlement. " The law firm that the Harris family

1797retained, Clark, Fountain, La Vista, Prather, Keen & Littky -

1807Rubin, LLP, has submitted the affidavit of Nancy La Vista,

1817Esquire, attesting that, if t he claimants were awarded $2

1827million under the claim bill at issue, the attorneys' fees would

1838be limited to $500,000, or 25 percent of the compensation

1849being sought.

1851RECOMMENDATIONS: For the reasons set forth above , I recommend that Senate

1862Bill 6 (2012 ) be reported FAVORABLY.

1869Respectfully submitted,

1871John G. Van Laningham

1875Senate Special Master

1878cc: Senator Joe Negron

1882Debbie Brown, Interim Secretary of the Senate

1889Counsel of Record

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Date
Proceedings
Date: 03/30/2012
Proceedings: End of 2012 Regular Session. CASE CLOSED.
PDF:
Date: 03/30/2012
Proceedings: Transmittal letter from Claudia Llado forwarding records to the agency.
PDF:
Date: 02/23/2012
Proceedings: Other
PDF:
Date: 02/23/2012
Proceedings: Special Master's Final Report released (transmitted to Senate President [February 23, 2012]).
PDF:
Date: 09/28/2011
Proceedings: Notice of Filing Amended Joint Report (as to corrected notice of publication only) filed.
PDF:
Date: 09/19/2011
Proceedings: Letter to T. Thomas from T. Heath regarding a response to a letter dated September 9, 2011 filed.
PDF:
Date: 09/12/2011
Proceedings: Letter to Counsel from T.Thomas regarding Claim bill filed.
PDF:
Date: 09/12/2011
Proceedings: Notice of Filing Joint Report filed.
PDF:
Date: 09/12/2011
Proceedings: Notice of Filing Joint Report filed.
PDF:
Date: 08/30/2011
Proceedings: Letter to parties of record from Judge Vanlaningham.
Date: 08/12/2011
Proceedings: DOAH Case files 10-9580CB and 11-0115CB (1 box returned from Senate; available for viewing in 10-9580CB and 11-0115CB) filed.
PDF:
Date: 08/12/2011
Proceedings: Senate Bill 6 filed.
PDF:
Date: 08/12/2011
Proceedings: Agency referral filed.

Case Information

Judge:
JOHN G. VAN LANINGHAM
Date Filed:
08/12/2011
Date Assignment:
08/15/2011
Last Docket Entry:
03/30/2012
Location:
West Palm Beach, Florida
District:
Southern
Agency:
Contract Hearings
Suffix:
CB
 

Counsels

Related Florida Statute(s) (1):