STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
YAMILE ACEBO, Parent and Natural Guardian of JASMINE ACEBO, a Minor,
Petitioner,
vs. CASE NO. 93-3000N
FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY COMPENSATION ASSOCIATION,
Respondent.
/
ORDER APPROVING STIPULATION AND JOINT PETITION OF CLAIM ARISING OUT OF FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY PURSUANT TO
CHAPTER 766, FLORIDA STATUTES
THIS CAUSE came on to be heard pursuant to Section 766.304, Florida Statutes, upon application of the above named parties for the entry of an Order approving the resolution of a formal Claim for Compensation Benefits heretofore filed in this cause in accordance with the provision of Chapter 766, Florida Statutes.
After due consideration of the interests of all parties, and being otherwise fully advised in the premises, it is
ORDERED that the stipulation of the parties filed June 30, 1993, is hereby approved and the parties are directed to comply with the provisions thereof.
DONE AND ORDERED in Tallahassee, Leon County, Florida, this 30th day of June 1993.
WILLIAM J. KENDRICK
District Hearing Officer
Division of Administrative Hearings The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-1550
(904) 488-9675
Copies furnished: Sonya Salkin, Esq.
Filed with the Clerk of the Division of Administrative Hearings this 30th day of June 1993.
315 S.E. 7th St., Ste. 300 Ft. Lauderdale, FL 33301
Charlton Lee Hunter, Esq.
150 S.E. 2nd Ave., Ste. 1200 Miami, FL 33131
Lynn Dickinson, Exec. Director Florida Birth-Related Neurological Injury Compensation Assoc.
Barnett Bank Bldg., Ste. 312
315 S. Calhoun St. Tallahassee, FL 32301
================================================================= NICA STIPULATION
=================================================================
STATE OF FLORIDA DIVISION OF ADMINISTRATION
CLAIMANTS: YAMILE ACEBO
parent and natural guardian of Jasmine Acebo, a minor
Represented By: Charlton Lee Hunter, Esquire
Law Offices of Charlton Lee Hunter
150 S. E. 2nd Avenue, Suite 1200 Miami, FL 33131; and
Sonya Salkin, Esquire
315 S. E. 7th Street Suite 300 Fort Lauderdale, FL 33301
ASSOCIATION: FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY COMPENSATION ASSOCIATION
RESPONDENTS: ROBERT SCHLICKER, M.D., MEMORIAL HOSPITAL, HOLLYWOOD FLORIDA and ANY AND ALL ADDITIONAI, HEALTH CARE PROVIDERS WHETHER KNOWN OR UNKNOWN INVOLVED IN THE MEDICAL TREATMENT OF THE INJURED PARTY
DATE OF INJURY: July 26, 1985
STIPULATION AND JOINT PETITION FOR COMPENSATION OF CLAIM ARISING OUT OF FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY PURSUANT TO CHAPTER 766, FLORIDA STATUTES
Claimant and the Association (Collectively the "Parties") hereby jointly petition for entry of an order by the Judge of Administrative Hearings approving this Stipulation and Joint Petition for Compensation (the "Stipulation") of all claims arising out of the birth-related neurological injury (the "Injury") suffered by Jasmine Acebo. The parties hereby stipulate that the facts contained herein are true and shall be considered as established by competent, substantial evidence before the Judge of Administrative Hearings:
Jasmine Acebo (the "Injured Party"), incurred an Injury as that term is defined by section 766.302(2), Florida Statutes, on or about July 26, 19g . The Injury that the Injured Party incurred was the sole and proximate cause of her current medical condition. The Injury occurred in Broward County, Florida and falls within the jurisdiction of the Judge of Administrative Hearings .
Yamile Acebo (the "Claimant") is the parent or lega1 guardian) of the Injured Party' and is the Claimant as defined by Section 766.302(3), Florida Statutes.
Memorial Hospital, Broward County Florida is the Hospital where the injury was incurred on July 26, 1989 as defined by Florida Statutes, Section 766.302(6).
Dr. Robert Schlicker is a participating physician as defined in Florida Statutes, Section 766.302(7).
The Claimant has filed a petition under Section 766.305, Florida Statutes, seeking compensation from the ,Association, and that petition is incorporated herein by reference in the entirety, including all attachments. Any reference made within this document to the Association encompasses, where appropriate, the Florida Birth-Related Neurological Injury Compensation Plan which the Association administers.
The Claimant, the Association on behalf of itself, and all Respondents, known or unknown, agree that the aforementioned Injury comes within the jurisdiction of the Judge of Administrative Hearings and is governed by Section 766.301, et, seq , Florida Statutes.
The Claimant and Association agree that the rights and remedies granted by this plan or account of the Injury shall exclude al1 other rights and remedies of such infant, her parents or next of kin at common law or otherwise, against any person or entity directly or indirectly involved with the 1abor delivery or resuscitation during which time the Injury occurred, arising out of or related to a medical malpractice claim with respect to such injuries and shall preclude any claim for medical malpractice against any person or entity.
The Claimant and the Association hereby agree as follows:
The Association agrees to an award of ONE HUNDRED THOUSAND AND NO/100 DOLLARS ( $100,000 .00 ) authorized pursuant to Section 766.31(l)(b), Florida Statutes. The amount of ONE THOUSAND SEVEN HUNDRED FIFTY-EIGHT AND NO/100 DOLLARS ($1,758.00)
has been advanced to Credit Claims and Collections on behalf of the Claimant and the amount of ONE THOUSAND FOUR HUNDRED TWENTY- TWO AND NO/100 DOLLARS ($1,422.00) has been advanced to Goodyear Tire & Rubber Company on behalf of the Claimant for payment of her outstanding debts. The claimant has requested the following payments be made to settle her previously incurred personal debt.
FIVE HUNDRED EIGHTY-SEVEN AND 69/100 DOLLARS ($587.69) to
State Farm Insurance Company; and TWO HUNDRED THIRTY-TWO AND 31/100 DOLLARS ($232.31) to Texaco, Inc.
TWO AND 31/100 DOLLARS ($232.31) to Texaco, Inc.
In addition, the claimant requests a payment of SIXTEEN THOUSAND AND NO/lOO DOLLARS ($16,000,00 ) for the purchase of a vehicle payable to Sun Chevrolet, Inc.
In addition, the Association shall pay EIGHTY THOUSAND AND NO/100 DOLLARS ($80,000,00) to the Claimant; for the purchase of an annuity. The annuity shall provide for a life payment plan with a minimum 30-year guaranteed payment plan to the custodial parent: of the Injured Party. The Claimant through her attorney shall notify the association to whom the payment; shall be made for the annuity. The Association retains no right of ownership to the annuity.
The Association will pay all benefits, past and future, as authorized by Section 766.31, Florida Statutes.
c ) The Association and Charlton Lee Hunter, Esquire, and Sonya Salkin, Esquire, attorneys for the Claimant, agree that a reasonable sum for services and certain expenses incurred in the representation of the Claimant in this case will determined at a future date. In absence of an agreement for a specific amount, either party may request a hearing for determination.
The Claimant further agrees that payments, including future payments agreed to herein above by the terms and provisions of this Stipulation are a full, complete and absolute discharge of any and all responsibility of the Respondents and the Association, not only to the Claimant in her officia1 capacity as the parent of the Injured Party; but also a full and complete discharge of whatever liability the Respondents and Association have, or may have, to Claimant in her personal capacity as parent of the Injured Party. The claimant further acknowledges that payment in full now and in the future as claims arise as provided herein above, shall result in a full and complete discharge as to any and all liability of the Respondents, or the Association, which they may have to any other relatives of the Injured Party.
The Claimant further agrees that there is no evidence of bad faith, malicious purpose or willful and wanton disregard of human rights, safety, or property on the part of any of the parties or of any person or entity mentioned within this stipulation that would otherwise support a civil action as provided in Section 766.303(2), Florida statutes. The Claimant also acknowledges that no civil suit has been filed, nor will be filed and if a suit or notice of intent has been filed and/or served it will hereby be immediately dismissed with prejudice by motion of the Claimant, against the Respondents or the Association or any other person or entity either known or unknown and so named as a result of the Injury sustained by the Injured Party. Nothing herein shall preclude the Claimant from assisting the Department of Professional Regulation in investigation or discipline of the physicians involved in the care of, or the birth of, the Injured Party.
The Claimant acknowledges to the Judge of Administrative Hearings that she understands this stipulation to be a complete and final settlement in its entirety; and further represents and acknowledges that she has retained .legal counsel which has provided legal advice in regard to this Stipulation, and the option of accepting this Stipulation as opposed to whatever other rights and remedies the Claimant otherwise had, either in her official capacity or personal capacity and that her legal counsel has advised her of the legal significance of each, and every part of this Stipulation. Further, the claimant represents and acknowledges to the Judge of Administrative Hearings that she understands that the Petition which has been filed seeking compensation from the Association is hereby deemed to be satisfied in its entirety, except to the extent provided as it pertains to the future payment of medical expense as authorized by Section 766.31, Florida Statutes.
The parties to this Stipulation agree that there will be no appeal of this Order when approved and entered by the Judge of Administrative Hearings approving this Stipulation.
It is understood by and between the parties that if this Stipulation is not approved by the Judge of Administrative Hearings, this Stipulation will be null, void and of no effect. It is stipulated and agreed by and between the parties that this stipulation shall be presented to the Judge of Administrative Hearings for his/her consideration and for the entry of a proper order of approval without the necessity of formal notice and as such, such notice is hereby expressly waived.
It is understood and agreed that when the Judge of Administrative Hearings approves this Stipulation, that this
Stipulation is not subject to modification or change, in any way, without the express written agreement between all parties to this Stipulation, except as provided in Paragraph 17,
References made in this Stipulation to the "parties" or all "parties" shall be deemed to include the Claimant in her capacity as parent and lega1 guardian of the injured party; the Respondents and the Association and any and all medical providers involved in the birth of the Injured Party.
In order for the Association to carry out its responsibility as provided in this Stipulation, the Claimant shall provide within thirty (30) days of the date of approval of this Stipulation, the following:
complete list (with copies, invoices, addresses, etc.) of all known past expenses for which the claimant seeks reimbursement in accordance with the terms and provisions of this Stipulation document for medical expenses previously incurred, and
A complete list, under oath. of any source of funds or payments of any kind or nature, whether from state or federal government, pre-paid health plan, health maintenance or organizations, or other providers of insurance collectively "insurance programs "); and
A fully executed authorization of release of any and all medical records, insurance program records, and such other authorization as may, from time to time, reasonably be required by the Association to complete its duties hereunder and
Such other reasonable information as may be required by the Association, regardless of when the point in time in which the information may be requested so long as this Stipulation is effective.
The Judge of Administrative Hearings shall retain jurisdiction to resolve any disputes as to interpretation of any provision of this Stipulation.
The foregoing has been read and is fully understood by the parties hereto who have executed same this 30 day of June, 1993.
LYNN DICKINSON, Executive Director Florida Birth-Related Neurological Injury compensation Association Barnett Bank Building
315 South Calhoun St, suite 312 Tallahassee, FL 32301
YAMILLE ACEBO
as C1aimant and natural guardian of JASMINE ACEBO, a minor
CHARLTON LEE HUNTER, ESQUIRE
150 S.E. 2nd Ave, Suite 1200 Miami, FL 33131; and
SONYA SALKIN, ESQUIRE
315 S.E. 7th Street, Suite 300 Fort Lauderdale, FL 33301
Attorneys for Claimant
RELEASE OF ALL CLAIMS
I, Samuel Hannah, believe that I may be the father of the Jasmine Acebo who was born at Memorial Hospital on July 26, 1989. I am aware of the fact that Jasmine's mother, Yamile Acebo, as the custodial parent of Jasmine Acebo, has made claim against the Florida Birth-Related Neurological Injury Compensation Association for benefits to be paid to both her and for the benefit of Jasmine Acebo. For and in consideration of the Florida Birth-Related Neurological Injury Compensation Association's agreement to make such payments to Yamile Acebo and Jasmine Acebo, I hereby waive, relinquish and release the Florida Birth-Related Neurological Injury Compensation Association, Robert Schickler, M.D., Memorial Hospital and any and all additional health care providers whether known or unknown involved in the medical treatment of Jasmine Acebo from any and all obligations that such entities and individuals may have to me as the father of Jasmine Acebo.
Samuel Hannah
Dated June 24, 1993
AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION
TO: Any and All Treating Physicians or Facilities
This document authorizes all physicians, dentists. optometrists, nurses, chiropractors, hospitals, clinics, laboratories, medical attendants and other health care providers who have participated In providing any care or service to:
Patient: Yamile Acebo Date of Birth: 4/3/69
to provide full and complete medical reports and records, including but not limited to patient histories, examination results, and test results, including reports or information pre pared by other persons that may be in your possession, and all
financial records, to the Florida Birth-Related Neurological Injury Compensation Association.
A photocopy of this document is as sufficient as the original. Dated this * day of *
*document filed with DOAH undated
Yamile Acebo Patient's Signature
| Issue Date | Document | Summary |
|---|---|---|
| May 20, 1994 | DOAH Final Order | Reasonable attorney`s fees established. Time records that were inadequate rejected as evidence of time reasonably expended. |
| Jun. 30, 1993 | DOAH Final Order | Order approving Stipulation and Joint Petition of Claim arising out of Florida Birth-related Neurological Injury Pursuant to Chapter 766, Florida Statutes. |
