STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

ALFREDO and YVONNE RODRIGUEZ, )

as parents and natural guardians ) of CALIXTO RODRIGUEZ, )

)

Petitioners, )

)

vs. ) CASE NO. 94-3615N

) FLORIDA BIRTH-RELATED NEUROLOGICAL ) INJURY COMPENSATION ASSOCIATION, )

)

Respondent. )

___________________________________)

FINAL ORDER OF DISMISSAL

This cause came on to be heard upon respondent's motion to dismiss, filed July 18, 1994, and the order to show cause, issued July 19, 1994.

STATEMENT OF THE CASE

1. By petition filed July 7, 1994, petitioners, Alfredo and Yvonne Rodriquez, as parents and natural guardians of Calixto Rodriguez (Calixto), a minor, sought benefits pursuant to Sections 766.301-766.316, Florida Statutes, the "Florida Birth-Related Neurological Injury Compensation Plan." The medical records attached to such petition affirmatively reflected that Calixto Rodriguez was born at 5:29 p.m., April 17, 1992, at Florida Hospital, Orlando, Florida, and that his weight at birth was 2,190 grams.

   
   

2. In response to such petition, respondent, Florida Birth-Related Neurological Injury Compensation Association (NICA), filed a notice of noncompensability. As a basis for its suggestion of noncompensability, NICA asserted that the "claim is not a `birth-related neurological injury' within the meaning of Section 766.302(2), Florida Statutes (1993) inasmuch as the infant, Calixto Rodriguez, weighed 2190 grams at birth thus failing to meet the statutorily mandated minimum weight requirement of 2500 grams as set forth in Section 766.302(2), Florida Statutes (1993) which encompasses the

   definition of `birth-related neurological injury'." Moreover, by motion filed July 18, 1994, NICA moved to dismiss the petition based on the medical records attached to the petition which affirmatively demonstrated that Calixto's weight at birth was less that 2500 grams.

   
   

3. On July 19, 1994, an order to show cause was rendered which observed that the medical records attached to the petition "affirmatively reflect that Calixto Rodriguez was born at 5:29 p.m., April 17, 1992, at Florida Hospital, and that his weight at birth was 2190 grams." Under the circumstances, petitioners were accorded fourteen (14) days to show good cause in writing, if any they had, why a final order dismissing the petition for benefits should not be rendered.

   
   

4. Petitioners did not file a response to the motion to dismiss or order to show cause.

   
   

   CONCLUSIONS OF LAW

   
   

5. The Division of Administrative Hearings has jurisdiction over the parties to, and the subject of, these proceedings. Section 766.301, et seq., Florida Statutes.

   
   

6. The Florida Birth-Related Neurological Compensation Plan (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. Section 766.303(1), Florida Statutes.

   
   

7. The injured "infant, his personal representative, parents, dependents, and next of kin," may seek compensation under the Plan by filing a claim for compensation with the Division of Administrative Hearings within five years of the infant's birth. Sections 766.302(3), 766.303(2), 766.305(1) and 766.313, Florida Statutes. The Florida Birth-Related Neurological Injury Compensation Association (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." Section 766.305(3), Florida Statutes.

   
   

8. If NICA determines that the injury alleged in a claim is a compensable birth-related neurological injury, it may award compensation to the claimant, provided that the award is approved by the Hearing Officer to whom the claim has been

   assigned. Section 766.305(6), Florida Statutes. If, on the other hand, NICA disputes the claim, as it has in the instant case, the dispute must be resolved by the assigned Hearing Officer in accordance with the provisions of Chapter 120, Florida Statutes. Sections 766.304, 766.307, 766.309 and

   766.31, Florida Statutes.

   
   

9. In discharging this responsibility, the Hearing Officer must make the following determinations based upon the available evidence:

   
   

   1. Whether the injury claimed is a birth- related neurological injury. If the claimant has demonstrated, to the satisfaction of the hearing officer, 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. 766.302(2).

   2. Whether obstetrical services were delivered

      by a participating physician in the course of labor, delivery, or resuscitation in the immediate post- delivery period in a hospital; or by a certified nurse midwife in a teaching hospital supervised

      by a participating physician in the course of labor, delivery, or resuscitation in the immediate post-delivery period in a hospital.

      
      

      Section 766.309(1), Florida Statutes. 1/ An award may be sustained only if the Hearing Officer concludes that the "infant has sustained a birth-related neurological injury and that obstetrical services were delivered by a participating physician at birth." Section 766.31(1), Florida Statutes.

      
      

10. Pertinent to this case, "birth-related neurological injury" is defined by Section 766.302(2), Florida Statutes, as follows:

    
    

    "Birth-related neurological injury" means injury to the brain or spinal cord of a live infant weighing at least 2,500 grams at birth

    caused by oxygen deprivation or mechanical injury occurring in the course of labor, delivery, or resuscitation in the immediate post-delivery period in a hospital, which renders the infant

    permanently and substantially mentally and physically impaired. This definition shall apply to live births only and shall not include

    disability or death caused by genetic or congenital abnormality.

    
    

11. Here, it affirmatively appears from the medical records attached to the petition that Calixto's weight at birth was 2190 grams. Such weight is less than the statutorily mandated minimum weight requirement of 2500 grams and, therefore, any injury Calixto may have suffered was not a "birth-related neurological injury" as defined by law. Accordingly, the subject claim is not compensable under the Plan. Sections 766.320(2) and 766.309(2), Florida Statutes.

    
    

12. Where, as here, "the hearing officer determines that the injury alleged is not a birth-related neurological injury

. . ., he [is required to] enter an order [to such effect] and

. . . cause a copy of such order to be sent immediately to the parties by registered or certified mail." Section 766.309(2), Florida Statutes. Such an order constitutes final agency action subject to appellate court review. Section 766.311(1), Florida Statutes.

CONCLUSION

Based on the foregoing findings of fact and conclusions of law, it is

ORDERED that the petition for compensation filed by petitioners, Alfredo and Yvonne Rodriguez as parents and natural guardians of Calixto Rodriguez, a minor, be and the same is hereby dismissed with prejudice.

DONE AND ORDERED in Tallahassee, Leon County, Florida, this 18th day of August 1994.

___________________________________ WILLIAM J. KENDRICK

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 18th day of August 1994.

ENDNOTE

1/ Where, as here, NICA disputes the claim, the burden rests on the claimant to demonstrate entitlement to compensation.

Section 766.309(1)(a), Florida Statutes. See, also, Balino v. Department of Health and Rehabilitative Services, 348 So.2d 349, 350 (Fla. 1st DCA 1977), ("the burden of proof, apart from statute, is on the party asserting the affirmative issue before an administrative tribunal").

COPIES FURNISHED:

(By certified mail)

George H. Anderson, III, Esquire Best and Anderson

20 North Orange Avenue #505 Orlando, Florida 32801

Lynn Dickinson, Executive Director Florida Birth-Related Neurological

Injury Compensation Association Post Office Box 1528

Tallahassee, Florida 32302

Sue Foster, Chief Bureau of Complaints Department of Business

and Professional Regulation Suite 60

1940 North Monroe Street Tallahassee, Florida 32399-0792

Ms. Tanya Williams

Division of Health Quality Assurance Hospital Section

Agency for Health Care Administration 2727 Mahan Drive

Tallahassee, Florida 32308

Bill O'Neil, Esquire General Counsel Department of Insurance The Capitol, PL-11

Tallahassee, Florida 32399-0300

Dr. Mark T. Cullen c/o Florida Hospital 601 East Rollins

Orlando, Florida 32803

Florida Hospital Legal Department 601 East Rollins

Orlando, Florida 32803

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this final order is entitled to judicial review pursuant to Sections 120.68 and 766.311, Florida Statutes. Review proceedings are governed by the Florida Rules Of Appellate Procedure. Such proceedings are commenced by filing one copy of a notice of appeal with the Agency Clerk Of The Division Of Administrative Hearings and a second copy, accompanied by filing fees prescribed by law, with the appropriate District Court of Appeal. See, Section 120.68(2), Florida Statutes, and Florida Birth-Related Neurological Injury Compensation Association v. Carreras, 598 So.2d 299 (Fla. 1st DCA 1992). The notice of appeal must be filed within 30 days of rendition of the order to be reviewed.

Docket for Case No: 94-003615N

Orders for Case No: 94-003615N