15-006067N Jessica Lynn Kolln And Dakota Blaize Small, As Parents And Natural Guardians Of Anna Virginia Small, Deceased vs. Florida Birth-Related Neurological Injury Compensation Association Status: Closed DOAH Final Order on Wednesday, May 18, 2016.

Summary: Final Order approving the Association's acceptance of the claim for compensation.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

JESSICA LYNN KOLLN AND DAKOTA

BLAIZE SMALL, as parents and

natural guardians of ANNA

VIRGINIA SMALL, deceased,

Petitioners,

vs. Case No. 15 - 6067N

FLORIDA BIRTH - RELATED

NEUROLOGICAL INJURY COMPENSATION

ASSOCIATI ON,

Respondent,

and

ERIKA D. GLAS, D.O., AND NORTH

FLORIDA OB/GYN, LLC,

Intervenors.

_______________________________/

FINAL ORDER APPROVING STIPULATION FOR ENTRY OF AWARD

This cause came on for consideration purs uant to sections

766.304 and 766.305(7), Florida Statutes, upon the Stipulation

and Joint Petition for Compensation of Claim Arising O ut of

Florida Birth - Related Neurological Injury Pursuant to Chapter

766, Florida Statutes (Stipulation and Joint Petition) , filed

with the Division of Administrative Hearings on May 17, 2016, for

the entry of an order approving the resolution of a claim for

compensation benefits filed in accordance with the provisions of

chapter 766 and a resolution of the exclusive remedy ot herwise

available as outlined in chapter 766.

By the terms of their stipulation, Petitioners, Jessica Lynn

Kolln and Dakota Blaize Small, as parents and natural guardians

of Anna Virginia Small , deceased, and Respondent, the Florida

Birth - Related Neurologi cal Injury Compensation Association

(NICA) , have agreed that Jessica Lynn Kolln and Dakota Blaize

Small are the parents and legal guardians of Anna Virginia Small

(Anna) deceased; that Anna was born a live infant on or about

October 20, 2015 , at Baptist Me dical Center , a ÐhospitalÑ as

defined by section 766.302(6) located in Jacksonville , Florida;

and that AnnaÓs birth weight exceeded 2,500 grams. The Parties

have further agreed that Erika Glas , M.D., provided obstetrical

services at Anna Ós delivery and wa s a Ðparticipating physicianÑ

in the Florida Birth - Related Neurological Injury Compensation

Plan, as defined by section 766.302(7). The Parties have agreed

that Anna suffered a Ðbirth - related neurological injury,Ñ as that

term is defined by section 766.30 2(2), which was the sole and

proximate cause of AnnaÓs death.

It is ORDERED:

1. The Stipulation and Joint Petition filed on May 17, 2016 ,

is hereby approved, and the Parties are directed to comply with

the provisions of the Stipulation and Joint Petition.

2. Petitioners, Jessica Lynn Kolln and Dakota Blaize Small ,

as the parents and legal guardians of Anna Virginia Small ,

deceased, are awarded one hundred thousand dollars ($100,000.00),

pursuant to section 766.31(1)(b)1 . , to be paid as a lump sum;

payment of benefits up to and including the effective date of the

Stipulation and Joint Petition pursuant to section 766.31(1)(a),

subject to the provisions of paragraph 20 of the Stipulation and

Joint Petition; and payment of the $10,000.00 death benefit

pursuan t to section 766.31(1)(b)1.

3. NICA will reimburse Matthew Sowell , attorney for

Petitioners, an agreed - upon attorneyÓs fee of $ 10,000.00 and

expenses of $ 500.00 , totaling $ 10,500.00 in full for services

rendered in the filing of this claim.

4. Upon the p ayment of the award of $100,000.00, the death

benefit of $10,000.00, past benefit/expenses, and $ 10,500.00 for

attorneyÓs fees and costs, the claims of Petitioners shall be

deemed fully satisfied and extinguished.

5. The Division of Administrative Hearing s retains

jurisdiction over this matter to resolve any disputes, should they

arise, regarding the P artiesÓ compliance with the terms of this

Order.

DONE AND ORDERED this 18th day of May , 2016 , in Tallahassee,

Leon County, Florida.

S

BARBARA J. STAROS

Administrative Law Judge

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399 - 3060

(850) 488 - 9675

Fax Filing (850) 921 - 6847

www.doah.state.fl.us

Filed with the Clerk of t he

Division of Administrative Hearings

this 18th day of May , 2016 .

COPIES FURNISHED:

(via certified mail)

Kenney Shipley, Executive Director

Florida Birth Related Neurological

Injury Compensation Association

2360 Christopher Place, Suite 1

Tallahassee , Florida 32308

(eServed)

(Certified Mail No. 7014 1200 0002 3330 6495)

Matthew W. Sowell, Esquire

Matthew W. Sowell, P.A.

233 East Bay Street , 8th Floor

Jacksonville, Florida 32202

(eServed)

(Certified Mail No. 7014 1200 0002 3330 6501)

Richard E. Ram sey, Esquire

Wicker, Smith, O'Hara,

McCoy and Ford, P.A.

50 North Laura Street , Suite 2700

Jacksonville, Florida 32202

(eServed)

(Certified Mail No. 7014 1200 0002 3330 6518)

Amie Rice, Investigation Manager

Consumer Services Unit

Department of Health

4052 Bald Cypress Way, Bin C - 75

Tallahassee, Florida 32399 - 3275

(Certified Mail No. 7014 1200 0002 3330 6525)

Elizabeth Dudek, Secretary

Health Quality Assurance

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 3 2308

(eServed)

(Certified Mail No. 7014 1200 0002 3330 6532)

Baptist Medical Center

Attention: Risk Management

800 Prudential Drive

Jacksonville, Florida 32204

(Certified Mail No. 7014 1200 0002 3330 9670)

NOTICE OF RIGHT TO JUDICIAL REVIEW

Review o f a final order of an administrative law judge shall be

by appeal to the District Court of Appeal pursuant to section

766.311(1), Florida Statutes. Review proceedings are governed by

the Florida Rules of Appellate Procedure. Such proceedings are

commence d by filing the original notice of administrative appeal

with the a gency c lerk of the Division of Administrative Hearings

within 30 days of rendition of the order to be reviewed, and a

copy, accompanied by filing fees prescribed by law, with the

clerk of t he appropriate District Court of Appeal. See

§ 766.311(1), Fla. Stat., and Fla. Birth - Related Neurological

Injury Comp. Ass'n v. Carreras , 598 So. 2d 299 (Fla. 1st DCA

1992).