16-005888N Jaya Krishna Sabbineni And Kavitha Nagalla, On Behalf Of And As Parents And Natural Guardians Of Sathvik C. Sabbineni, A Minor vs. Florida Birth-Related Neurological Injury Compensation Association Status: Closed DOAH Final Order on Thursday, March 22, 2018.

Summary: The claim was not compensable because the infant did not sustain a "birth-related neurological injury" as that term is defined in section 766.302(2), Florida Statutes.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

JAYA KRISHNA SABBINENI AND

KAVITHA NAGALLA, on behalf of

and as parents and natural

guardians of SATHVIK C.

SABBINENI, a minor,

Petitioners,

vs. Case No. 16 - 5888N

FLORIDA BIRTH - RELATED

NEUROLOGICAL INJURY COMPE NSATION

ASSOCIATION,

Respondent.

_______________________________/

SUMMARY FINAL ORDER OF DISMISSAL

This cause came on for consideration upon a Motion for

Summary Final Order filed by Respondent, Florida Birth - Related

Neu rological Injury Compensation Association (NICA), on

February 12, 2018. 1 /

STATEMENT OF THE CASE

On October 5, 2016, Petitioners, Jaya Krishna Sabbineni and

Kavitha Nagalla, as parents and natural guardians of Sathvik C.

Sabbineni (Sa t hvik), a minor , filed a Petition for Benefits

Pursu ant to Florida Statu t e Section 766.301 et seq. (Petition)

with the Division of Administrative Hearings (DOAH) for the

determination of compensability under the Florida Birth - Related

Neurological Injury Compensation Plan (Plan). The Petition named

Jeannine V. Mauney, M.D. , and Nat a sha Eliz, M.D., as the

physicians who provided obstetric services for the birth of

Sa t hvi k on October 21, 2014, at St. VincentÓs Medical Center in

Jacksonville, Florida.

DOAH served NICA and St. VincentÓs Medical Center with a

copy of the Petition on October 17, 2016. Jeannine V .

M auney, M.D. , was served with a c opy of the Petition on

December 2, 2016 .

On February 12, 2018, NICA filed a Motion for Summary Final

Order, requesting that a summary final order be entered finding

that the claim was not compensable because Sathvik did not

sustain a Ðbirth - related neurological injuryÑ as that term is

defined in section 766.302(2), Florida Statutes.

On February 20, 2018, the undersigned i ssued an Order to

Show Cause, ordering Petitioners to show cause in writing, on or

before February 27, 2018, why RespondentÓs motion should not be

granted and an order entered determining that the instant claim

is not compensable.

On February 26, 2018, Pe titioner s filed a motion to extend

the time to respond to the Order to Show Cause to March 14, 2018.

Petitioners represented that they were working with medical

experts to provide a report related to the subject minor. On

February 27, 2018, Respondent fi led a response to Petitioner s Ó

motion and represented it had no objection to the request;

however, requested that the final hearing be continued to provide

the parties sufficient time to conduct additional discovery, if

necessary, based upon the anticipate d expert reports to be filed

by Petitioner s .

On February 28, 2018, the undersigned issued an Order

Granting Continuance. Said Order granted Petitioner s Ó motion for

extension of time to respond to the Order to Show Cause on or

before March 14, 2018 . Said O rder further found good cause for

continuance of the final hearing, and cancelled the final hearing

previously scheduled for March 29, 2018. Petitioners did not

file a response to the Order to Show Cause.

F INDINGS OF FACT

1. Sathvik was born on Octob er 21, 2014, at St. VincentÓs

Medical Center in Jacksonville, Florida.

2. Donal d Willis, M.D., a n obstetrician specializing in

maternal - fetal medicine, was requested by NICA to review the

medical records of Sathvik , to opine whether an injury occurred

i n the course of labor, delivery or resuscitation in the

immediate postdelivery period at St. VincentÓs due to oxygen

deprivation or mechanical injury . In a report dated November 18,

2016, Dr. Willis described his findings in pertinent part as

follows:

In summary, the baby was delivered at term

and was not depressed at birth. Apgar scores

were 8/9. Cord bloo d pH was normal at 7.37.

The baby had a benign newborn hospital course

and was discharged home on DOL (day of

life) 2.

There was no apparent obs tetrical event that

resulted in loss of oxygen or mechanical

trauma to the babyÓs brain during labor,

delivery or the immediate post delivery

period.

3. Attached to RespondentÓs Motion for Summary Final Order

is the affidavit of Dr. Willis, dated February 6, 2018. In his

affidavit, Dr. Willis affirms his November 18, 2016, report and

maintains that his opinions are within a reason able degree of

medical probability.

4. NICA also retained Laufey Y. Sigurdardottir, M.D., a

pediatric neurologi st, to review SathvikÓs medical records and

conduct an Independent Medical Examination and opine as to

whether he suffers from a permanent and substantial mental and

physical impairment as a result of a birth - related neurological

injury. Dr. Sigurdardotti r reviewed the medical records,

obtained a full historical account from SathvikÓs parents, and

performed a full neurological evaluation on January 11, 2017.

5. In a report authored after the neurologic evaluation,

Dr. Sigurdardottir summarized her findings as follows:

Summary: Here we have a 2 - year 3 - month old,

ex full - term infant, born via vaginal

delivery, with a single late deceleration

approximately 2 hours prior to birth. He had

no signs of perinatal encephalopathy but was

diagnosed with a l eft hemiplegic CT at 6

months of age. He was found to have

evidence, on head ultrasound, of a remote

stroke. At this time, it is difficult to

establish the timing of his stroke. He has a

mild language delay, but no signs of a more

severe global cognitiv e delay. His motor

impairment is substantial. He is in all

therapy services at this time. He does have

treated epilepsy.

6. In response to whether Sathvik suffers from a permanent

and substantial mental and physical impairment,

Dr. Sigur dardot tir opined in h er report that, ÐSathvik is found

to have a substantial physical impairment with a left spastic

hemiplegia, but a nonsubstantial cognitive impairment, with a

mild expressive language delay. Ñ

7. In response to whether such an impairme nt is consistent

with a neurologic injury to the brain or spinal cord acquired due

to oxygen deprivation or mechanical injury, and, if so, whether

the injury is felt to be labor and birth related,

Dr. Sigurdardottir opined in her report that, Ð[i]n review of

available documents, his injury is felt to be acquired due to

oxygen deprivation of the brain, but it is unclear that this

injury is birth related.Ñ

8. Finally, in response to SathvikÓs prognosis and estimate

of life expectancy, Dr. Sigurdardot tir opined in h er report that,

Ð[t]he prognosis for full motor recovery is poor. The prognosis

for mental abilities is excellent. They estimate a life

expectancy is normal.Ñ Her report concluded that, Ð[i]n light of

his normal cognitive abilities, apart from a mild expressive

language delay, and the difficulty with timing of his ischemic

injury, I do not feel that Sathvik should be included in the NICA

Program.Ñ

9. RespondentÓs Motion for Summary Final Order also relies

upon the attached affidavi t from Dr. Sigurdardottir, dated

February 8, 2018. In her affidavit, she affirms the findings

contained in her report and affirms that her opinions are within

a reasonable degree of medical probability.

10. A review of the file reveals that no con trary evidence

was presented to dispute the findings and opinions of Dr. Willis

and Dr. Sigurdardottir. Their opinions are credited.

CONCLUSIONS OF LAW

11 . DOAH has jurisdiction over the parties to and the

subject matter of these proceedings. §§ 766.3 01 - 766.316, Fla.

Stat.

1 2 . The Plan was established by the Legislature "for the

purpose of providing compensation, irrespective of fault, for

birth - related neurological injury claims" relating to births

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

1 3 . The injured infant, her or his personal representative,

parents, dependents, and next of kin may seek compensation under

the Plan by filing a claim for compensation with DOAH.

§§ 766.302(3), 766.303(2), and 766.305(1), Fla. Stat. NICA,

which administers the Plan, has "45 days from the date of service

of a complete claim . . . in which to file a response to the

petition and to submit relevant written information relating to

the issue of whether the injury is a birth - related neurological

injury." § 766.305(4), Fla. Stat.

1 4 . NICA has determined that Petitioner does not have a

claim that is compensable under the Plan and has filed a Motion

for Summary Final Order, requesting that an order be entered

finding that the claim is not compens able.

1 5 . In ruling on the motion, the administrative law judge

must make the following determination based upon the available

evidence:

(a) Whether the injury claimed is a birth -

related neurological injury. If the claimant

has demonstrated, to the sati sfaction of the

administrative law judge, that the infant has

sustained a brain or spinal cord injury

caused by oxygen deprivation or mechanical

injury and that the infant was thereby

rendered permanently and substantially

mentally and physically impaired, a

rebuttable presumption shall arise that the

injury is a birth - related neurological injury

as defined in s. 766.303(2).

§ 766.309(1), Fla. Stat.

1 6 . The term "birth - related neurological injury" is defined

in section 766.302(2) as follows:

"Birth - re lated neurological injury" means

injury to the brain or spinal cord of a live

infant weighing at least 2,500 grams for a

single gestation or, in the case of a

multiple gestation, a live infant weighing at

least 2,000 grams at birth caused by oxygen

depriva tion or mechanical injury occurring in

the course of labor, delivery, or

resuscitation in the immediate postdelivery

period in a hospital, which renders the

infant permanently and substantially mentally

and physically impaired.

17 . The evidence fails to establish that there was an

obstetrical event that resulted in loss of oxygen or mechanical

trauma to SathvikÓs brain or spinal cord during labor, delivery,

or the immediate post - delivery period. Even if the eviden ce had

established that Sathvik had sust ained a stroke in the course of

labor, delivery, or resuscitation in the immediate postdelivery

period, the unrefuted evidence established that Sathvik did not

sustain a permanent and substantial mental impairment. Thus,

Sathvik did not sustain a birth - re lated neurological injury as

defined in section 766.302(2), Florida Statutes, and, therefore,

is not eligible for benefits under the Plan.

CONCLUSION

Based upon the foregoing Findings of Fact and Conclusions of

Law, it is ORDERED that the Petition is dis missed with prejudice.

DONE AND ORDERED this 22nd day of March , 2018 , in

Tallahassee, Leon County, Florida.

S

TODD P. RESAVAGE

Administrative Law Judge

Division of Administrative Hearings

The DeSoto Building

1230 Apalac hee Parkway

Tallahassee, Florida 32399 - 3060

(850) 488 - 9675

Fax Filing (850) 921 - 6847

www.doah.state.fl.us

Filed with the Clerk of the

Division of Administrative Hearings

this 22nd day of March , 2018 .

ENDNOTE

1/ RespondentÓs Motion for Summary Final O rder was filed on

October 30, 2017. Said motion represented that affidavits from

the medical experts would be filed subsequently in support of the

motion. RespondentÓs Notice of Filing Affidavits in support of

RespondentÓs Motion for Summary Final Order w as filed on

February 12, 2018. Accordingly, the undersigned construes

RespondentÓs Motion and supporting affidavits as filed on

February 12, 2018.

COPIES FURNISHED:

(via certified mail)

Kenney Shipley, Executive Director

Florida Birth Related Neurolo gical

Injury Compensation Association

Suite 1

2360 Christopher Place

Tallahassee, Florida 32308

(eServed)

(Certified Mail Number 7016 0910 0001 7980 1987)

M. Mark Bajalia, Esquire

Bajalia Law

Suite 301

11512 Lake Mead Avenue

Jacksonville, Florida 32 256

(eServed)

(Certified Mail Number 7016 0910 0001 7980 1994)

Jaya Krishna S abbineni

Kavitha Nagalla

Apartment 2206

8074 Gate Parkway West

Jacksonville, Florida 32216

(eServed)

(Certified Mail Number 7016 0910 0001 7980 2007)

Amie Rice, Investigation Manager

Consumer Services Unit

Department of Health

4052 Bald Cypress Way, Bin C - 75

Tallahassee, Florida 32399 - 3275

(Certified Mail Number 7016 0910 0001 7980 2014)

Justin Senior , Secretary

Health Quality Assurance

Agency for Health Care Administration

2 727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308

(eServed)

(Certified Mail Number 7016 0910 0001 7980 2021)

Jeann in e V. Mauney, M.D.

St. VincentÓs OB/GYN

Suite 204

4203 Belfort Road

Jacksonville, Florida 32216

(Certified Mail Number 7016 0910 000 1 7980 2038 )

Natasha Eliz , M.D.

St. VincentÓs OB/GYN

Suite 204

4203 Belfort Road

Jacksonville, Florida 32216

(Certified Mail Number 7016 0910 0001 7980 2045 )

St. VincentÓs Medical Center

Attention: Risk Management

4201 Belfort Road

Jacksonville, Flor ida 32216

(Certified Mail Number 7016 0910 0001 7980 2052 )

NOTICE OF RIGHT TO JUDICIAL REVIEW

Review of 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

commenced 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 the appropriate District Court of Appeal. See

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

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

1992).