Findings Of Fact Alyssa York was born on June 11, 2014, at Baptist Medical Center South located in Jacksonville, Florida. Alyssa weighed 4,026 grams at birth. Donald Willis, M.D. (Dr. Willis), was requested by NICA to review the medical records for Alyssa. In a medical report dated December 8, 2016, Dr. Willis opined as follows: In summary, delivery was complicated by a shoulder dystocia. The newborn was not depressed with a 5 minute Apgar score of 8. Resuscitation after delivery required only tactile stimulation and blow-by oxygen. The baby had an Erb’s palsy, but otherwise an uncomplicated newborn hospital course. There was no apparent obstetrical event that resulted in loss of oxygen or mechanical trauma to the baby’s brain or spinal cord during labor, delivery or the immediate post delivery period. NICA retained Laufey Y. Sigurdardottir, M.D. (Dr. Sigurdardottir), a pediatric neurologist, to examine Alyssa and to review her medical records. Dr. Sigurdardottir examined Alyssa on December 2, 2016. In a medical report regarding her independent medical examination of Alyssa, Dr. Sigurdardottir opined as follows: Summary: Alyssa is a 2-1/2 year-old who suffered a brachial plexus injury during a vaginal delivery complicated by a 1 minute shoulder dystocia. At the current age of 2 years 5 months she has a functional deficit that seems relatively mild and has not needed surgical intervention at this time. Her cognition, mental abilities seem age appropriate. In light of the above, my results are the following: Result as to question 1: Alyssa is found to have a mild physical impairment, but no noted mental impairment at this time. Result as to question 2: The brachial plexopathy is most likely due to injury sustained during the birthing process. Results as to question 3: The prognosis for full recovery is regarded [sic] as she continues to have functional limitations in her right arm. She however has normal abilities in other areas and her cognition is completely normal. In light of this, I do not recommend Alyssa to be included in the NICA program. I will be happy to answer additional questions. A review of the file in this case reveals that there have been no expert opinions filed that are contrary to the opinion of Dr. Willis that there was no apparent obstetrical event that resulted in loss of oxygen or mechanical trauma to the baby's brain or spinal cord during labor, delivery or the immediate post-delivery period. Dr. Willis’ opinion is credited. There are no contrary expert opinions filed that are contrary to Dr. Sigurdardottir’s opinion that Alyssa has a mild physical impairment but is not found to have a mental impairment at this time. Dr. Sigurdardottir’s opinion is credited.
The Issue At issue is whether Christopher White-Maldonado, a minor, qualifies for coverage under the Florida Birth-Related Neurological Injury Compensation Plan.
Findings Of Fact Preliminary findings Petitioner, Susanna Maldonado, is the natural mother and guardian of Christopher White-Maldonado, a minor. Christopher was born a live infant on January 1, 2000, at Orlando Regional Healthcare System, Inc., d/b/a Arnold Palmer Hospital, a hospital located in Orlando, Florida, and his birth weight exceeded 2,500 grams. The physician providing obstetrical services at Christopher's birth was Virgil Davila, M.D., who, at all times material hereto, was a "participating physician" in the Florida Birth-Related Neurological Injury Compensation Plan, as defined by Section 766.302(7), Florida Statutes. Coverage under the Plan Pertinent to this case, coverage is afforded by the Plan for infants who suffer a "birth-related neurological injury," defined as an injury to the brain . . . caused by oxygen deprivation 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." § 766.302(2), Fla. Stat. See also §§ 766.309 and 766.31, Fla. Stat. Here, the medical records and the results of a neurological examination by Michael Duchowny, M.D., a physician board-certified in pediatrics, neurology with special competence in child neurology, and clinical neurophysiology, demonstrate, and Petitioner agrees, that Christopher does not suffer from a substantial mental or physical impairment, much less a permanent and substantial mental and physical impairment, as required for coverage under the Plan.1 (Respondent's Exhibits 1-7, Transcript page 10 and 11). Consequently, the claim is not compensable, and it is unnecessary to resolve whether Christopher's impairments resulted from brain injury caused by birth trauma (oxygen deprivation or mechanical injury), as advocated by Petitioner, or whether they are developmentally based, as advocated by Respondent.
The Issue At issue in the proceeding is whether Roger Demetrick, a minor, suffered an injury for which compensation should be awarded under the Florida Birth-Related Neurological Injury Compensation Plan.
Findings Of Fact Fundamental findings Amy Demetrick is the mother and natural guardian of Roger Demetrick, a minor. Roger was born a live infant on January 19, 1997, at St. Vincent's Medical Center, a hospital located in Jacksonville, Florida, and his birth weight was in excess of 2,500 grams. The physician providing obstetrical services during the birth of Roger was Timothy Michael Phelan, M.D., who was at all times material hereto a "participating physician" in the Florida Birth-Related Neurological Injury Compensation Plan, as defined by Section 766.302(2), Florida Statutes. Roger's birth and subsequent development Mrs. Demetrick presented at St. Vincent's Medical Center the morning of January 19, 1997, in active labor. Apart from being pre-term, with the fetus at 36 weeks gestational age, Mrs. Demetrick's prenatal course was uncomplicated, and on admission fetal heart rate was noted within normal limits. Mrs. Demetrick's labor progressed steadily, and external fetal monitoring reflected a normal fetal heart rate throughout the course of labor. At about 10:44 a.m., spontaneous rupture of the membranes occurred, with clear amniotic fluid noted, and at 12:42 p.m., Roger was delivered by vaginal vertex presentation without difficulty, with clear amniotic fluid again noted. At delivery, Roger was noted to be somewhat poorly perfused, and was accorded blow-by oxygen for several minutes. Otherwise, no abnormalities were noted. Apgar scores were 8 at one minute and 9 at five minutes. The Apgar scores assigned to Roger are a numerical expression of the condition of a newborn infant, and reflect the sum points gained on assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and color, with each category being assigned a score ranging from the lowest score of 0 through a maximum score of 2. As noted, at one minute, Roger's Apgar score totaled 8, with heart rate, respiratory effort, muscle tone, and reflex irritability being graded at 2 each, and color being graded at 0. At five minutes, Roger's Apgar score totaled 9, with heart rate, respiratory effort, muscle tone, and reflex irritability again being graded at 2 each, and color being graded at 1. Such scores may reasonably be described as normal. Following delivery, Roger was transferred to the special care nursery. His course post-delivery is summarized by his attending physician, Arthur J. Vaughn, M.D., as follows: . . . The infant was brought to the special care nursery at St. Vincent's Medical Center and had intermittent tachypnea, pale appearance and arterial blood gases were obtained from the right radial artery. The arterial blood gases on room air revealed pH 7.29, PCO2 42, PO2 72 and a -7.2 base deficit. The infant was kept in the special care nursery and developed progressive tachypnea and retractions and repeat arterial blood gases revealed pH 7.21, PCO2 56, PO2 141 and a -7.4 base deficit. The infant was placed on hypo C-PAP and a right posterior tibial peripheral arterial line was placed by Dr. Carzoli. The infant improved on the C- PAP and the course and baby's chest x-rays were consistent with retained fetal lung fluid. The infant was able to be weaned off hypo C-PAP and off oxygen in approximately twenty-four hours. The infant then had a course consistent with a premature growing infant. The infant had intravenous antibiotics started at the time of the respiratory distress and work up was essentially negative and these antibiotics were discontinued at seventy-two hours. The infant developed some mild jaundice with a peak bilirubin level of 14.5. This jaundice resolved without treatment. The infant otherwise has been normal. He did have some problems with poor suck, swallow coordination and did require some initial nasogastric supplementation but the infant over the past several days has been taking p.o. and breast feeds well, not requiring any nasogastric feeds. The infant has continued to gain weight and keep down a normal temperature and is thus ready for discharge. The infant did have mild anemia evidenced on his hematocrit yesterday. The hematocrit was 34. The infant is to be started on Fer-In-Sol. Roger was discharged to his mother's care on January 28, 1997. Physical examination on discharge revealed: . . . a well developed, well nourished active mildly pale white male in no acute distress. HEENT - negative. Lungs - clear to percussion and auscultation in no distress. Heart - regular rate and rhythm without murmurs. Normal pulses. Abdomen - benign. No masses, organomegaly or tenderness. The abdomen is soft and nondistended. Genitourinary - normal male, recent circumcision with no active bleeding. Hips are normal without hip clicks. Neurologic - intact. Discharge diagnosis was as follows: Prematurity at thirty-three [sic] weeks. Respiratory distress - retained fetal lung fluid. Jaundice related to prematurity. Anemia - related to prematurity. Observation - sepsis. Diet - breast on demand, supplement as needed with formula. Roger was first seen by Henry Abram, M.D., his current neurologist, on June 25, 1998, at 1 1/2 years of age. Dr. Abram described the results of his examination and Roger's development following his discharge from St. Vincent's Medical Center as follows: This youngster has a complex medical history. He was born to a 27-year-old mother and was the 5 lb, 14 oz product of a 36 week gestation. The pregnancy was complicated by a viral illness at 28 weeks of gestation concurrent with weight loss, severe vomiting and diarrhea. At that time, there were some significant stresses with her marriage. Delivery was at St. Vincent's Hospital here in Jacksonville. Delivery was vaginal. Apgar scores were reported to be 8 and 9. The child had a 9-day stay in the nursery and for two days he was apparently mechanically ventilated. There were no reported neurological concerns. Developmental issues arose at approximately 6-7 months, when he was not developing normally. The mother initially admits to being in denial with these concerns, attributing the delay to his minimal prematurity. At approximately a year of age, he was referred to a developmentalist at Mercer University in Macon, when he was felt to be severely delayed. The issue of seizures came to attention in April of this year when he had an approximate 30-second generalized episode of stiffening and eye rolling. This resulted in a child neurology consultation with Dr. Janas, who was doing an outreach clinic from Atlanta in Macon. Her history is excellent and is present for my review today. She obtained a history of probably infantile spasms since early infancy. The mother is uncertain of when the movements began, but believes it was approximately 6-9 months of age. These spasms consisted of clusters seen throughout the day. The child would drop his head and shoulders forward, and his arms would come in to his chest. She initially attributed these to abdominal cramping, and it was only when the child had a prolonged seizure that these past episodes became highlighted. An EEG performed in April was felt to be hypsarrhythmic. Dr. Janas' notes clearly document significant global delay. She noted diffuse hypotonia on examination. The child's work-up at that time included an MRI scan of the brain. By report, this is felt to reveal prior ischemic injury to the right cerebral hemisphere. The child's metabolic evaluation reported a "normal" CBC, SMA-25, thyroid function tests and carnitine studies. Further studies reported to be performed included serum amino acids, urine for organic acids, urine for metabolic screen, serum lactate and chromosomes. The results of these studies are not available to me today. The child was begun on Phenobarbital in late April because of the spasms. However, within a week a diffuse "measles-like" rash developed. This medication was discontinued and the child was begun on Klonopin, and currently is on a dose of 1/2 tablet (0.5 mg tablets) given b.i.d. Initially this medication appeared to improve his seizures, however, for the past several weeks the spasms persisted daily. The child had an EEG performed at Nemours on 6/23/98. This was felt to be abnormal because of diffuse disorganization and slowing, as well as independent right and left hemisphere epileptiform discharges. * * * PHYSICAL EXAMINATION: Weight 12 kg. Head circumference 47 cm (30th percentile). The child was alert in appearance, but obviously markedly delayed. He was nonverbal and had few purposeful movements. Prominent fisting of the left arm was noted with increased tone noted in that extremity. Overall, his muscle tone appeared diminished, particularly in the lower extremities, however, DTR's were 2+ and symmetrical with a predominantly flexor plantar response. Withdrawal to light tactile stimulation was brisk and symmetrical. Cranial nerves II-XII appeared intact. Eye movements were full and conjugate. Pupils were equal and reactive to light. Brief glimpses of the fundi were unremarkable. The tongue was midline. GENERAL EXAM: HEENT: There were no cranial bruits. There were no dysmorphic features. CHEST: Clear. HEART: Regular rhythm without murmurs. ABDOMEN: Soft without organomegaly. SKIN: Without significant markings or rashes. In summary, this is a complex history in this 18-month-old youngster in whom there are many concerns. First, I agree that the child is severely and globally delayed, and there is a left spastic hemiparesis evident on exam. This is consistent with the MRI findings. It appears that the child did have a perinatal1 infarct, the etiology of which is, at this time, unclear. The child continues to have, by maternal description, infantile spasms. This has likely been a problem for at least the past year, and currently is unresponsive to Klonopin. I had a lengthy discussion with the mother discussing my concerns and recommendations. We discussed predominantly various anticonvulsant choices for the child's spasms. At this time, these are predominantly the three medication options: ACTH, Valproic acid, and Topiramate . . . . After a lengthy discussion . . . with the above options, the following recommendations were discussed and agreed upon: . . . [b]egin a trial of Topiramate [,] [r]eturn in one month's time for follow-up . . . [,] [and] continue with current OT, PT and ST. . . . It is my hope that Topiramate will abate the current infantile spasms, and be an effective long-term anticonvulsant for this youngster. I anticipate that he will continue to have severe delay and seizures and the need for special therapies will be a life-long concern. Roger's seizure disorder (epilepsy) has proven intractable, and he is currently described by Dr. Abram as a child with severe static encephalopathy and profound developmental delay. In Dr. Abram's opinion, Roger is permanently and substantially mentally and physically impaired secondary to a brain injury. As for the etiology of that injury, Dr. Abram has offered no opinion of record. Coverage under the Plan Pertinent to this case, coverage is afforded under the Plan when the claimant demonstrates, more likely than not, that the infant suffered an "injury to the brain . . . 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."2 Sections 766.302(2) and 766.309(1)(a), Florida Statutes. Here, NICA does not dispute that, as observed by Dr. Abram, Roger is permanently and substantially mentally and physically impaired secondary to a brain injury. What is at issue is whether the injury Roger suffered was "caused by oxygen deprivation or mechanical injury occurring in the course of labor, delivery, or resuscitation in the immediate post-delivery period." As to that issue, it must be resolved, as contended by NICA, that the record fails to demonstrate with the requisite degree of certainty that Roger's injury is related to oxygen deprivation or any other event that occurred during labor, delivery, or resuscitation in the immediate post-delivery period. The cause and timing of Roger's brain injury To address the cause and timing of Roger's injury, the parties offered selected records relating to Mrs. Demetrick's antepartum and intrapartum course, as well as for Roger's birth and subsequent development. The parties also offered the opinions of two physicians by deposition (Dr. Michael S. Duchowny, a physician board-certified in neurology with special competence in child neurology, and Dr. Charles Kalstone, a physician board-certified in obstetrics), as well as the observation of Mrs. Demetrick and Christine Hambelton. The medical records and other proof have been carefully considered. So considered, it must be resolved that the proof fails to demonstrate, more likely than not, that Roger's injury was associated with oxygen deprivation or other traumatic event occurring during the course of labor, delivery, or resuscitation in the immediate post-delivery period. In so concluding, it has not been overlooked that Dr. Abram was of the opinion that Roger's injury was the apparent result of a "perinatal infarct" or, as stated elsewhere in the records, the result of a "perinatal vascular accident ('strokes')." However, as heretofore noted, the perinatal period, which is not otherwise defined of record, is commonly understood to pertain to "the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth."3 Notably, Dr. Abram did not further refine the period during which he was of the opinion Roger's injury occurred (i.e., as having occurred during labor, delivery, or resuscitation in the immediate post- delivery period) or offer any explanation as to the cause of his injury. Contrasted with the paucity of proof offered by Petitioner to establish the cause and timing of Roger's injury, NICA offered the opinions of Doctors Duchowny and Kalstone who were of the view that there was no clinical evidence of any hypoxic or traumatic event having occurred during the course of Roger's birth consistent with brain injury and, consequently, that the injury he suffered was, most likely, acquired prior to the onset of labor. In so concluding, these physicians observed that Mrs. Demetrick's labor and delivery were uncomplicated; fetal monitoring (up to 2 minutes of delivery) was normal and showed no evidence of fetal distress; that on delivery Roger's Apgars were normal and he required no special assistance other than blow by oxygen; that his blood gases within an hour of delivery were normal; and there were no post-delivery complications to suggest Roger had suffered any injury to his brain during the course of labor, delivery or resuscitation in the immediate post-delivery period. Such opinions are grossly consistent with the record, are founded on a logical premise, and are accepted as credible and persuasive.
The Issue At issue in this proceeding is whether Justo Angel Aguiar, Jr., a minor, weighed at least 2500 grams at birth.
Findings Of Fact Preliminary matters Blanca Mejia and Justo Angel Aguiar, Sr., are the parents and natural guardians of Justo Angel Aguiar, Jr. (Justo), a minor. Justo was born a live infant on May 26, 1990, at Jackson Memorial Hospital, a teaching hospital located in Miami, Dade County, Florida. The physician providing obstetrical services during the birth of Justo was Mary Ann Sarda-Maduro, M.D., who was, at all time material hereto, a participating physician in the Florida Birth-Related Neurological Injury Compensation Plan, as defined by Section 766.302(7), Florida Statutes. Justo's birth At or about 12:26 a.m., May 26, 1990, Blanca Mejia (Ms. Mejia) was admitted to Jackson Memorial Hospital in active labor, with complaints of abdominal pain since 7:00 p.m.. At the time, Justo was preterm, with an estimated gestational age of 36 weeks. Ms. Mejia's progress record reflects that at 2:35 a.m., the fetal heart rate was at 120-130 beats per minute, with good beat to beat variability, but severe variable decelerations in the 60 beat per minute range were noted, with some late return to baseline. Vaginal exam revealed the cervix to be at 6 centimeters, effacement complete, and the fetus at station 0, with no amniotic fluid present. Ms. Mejia was infused, and at 4:10 a.m., May 26, 1990, Justo was delivered. Upon delivery, Justo was noted to be very floppy, with minimal response to stimulation, and suffering severe respiratory distress. Apgars were 4, 5, and 6, at one, five and ten minutes, respectively. Justo was suctioned, bagged and intubated, and transferred to the neonatal intensive care unit. Pertinent to this case, Justo was admitted to the neonatal intensive care unit at 4:28 a.m., May 26, 1990. At that time, certain vital statistics were taken and entered on the "neonatal nursing admission interview" sheet, including Justo's weight, which was recorded as 2,340 grams. Following his admission to the neonatal intensive care unit, Justo's weight was closely monitored, as his progress records reflect. As documented by those records, Justo's weight progress over the ensuing days was noted as follows: May 27, 1990, 2340 grams; May 28, 1990, 2325 grams; May 29, 1990, 2325 grams; May 30, 1990, 2320 grams; May 31, 1990, 2300 grams; June 1, 1990, 2305 grams; June 2, 1990, 2325 grams; June 3, 1990, 2325 grams; June 4, 1990, 2410 grams; June 5, 1990, 2445 grams; June 6, 1990, 2440 grams, June 7, 1990, 2450 grams; and June 8, 1990, 2450 grams. Finally, on June 9, 1990, two weeks after birth, Justo's weight finally achieved 2500 grams. Of a similar nature are the observations regarding Justo's weight recorded on the neonatal flow sheets, classification of newborns sheet, consultation reports, and the admission physical to the neonatal intensive care unit. [Respondent's exhibit 1]. Given the proof, Justo's weight at birth was, more likely than not, 2340 grams.
The Issue Whether Brittany C. Story has suffered an injury for which compensation should be awarded under the Florida Birth-Related Neurological Injury Compensation Plan, as alleged in the claim for compensation.
Findings Of Fact Brittany C. Story is the natural daughter of Constella Story. She was born on January 10, 1990, at Broward General Medical Center, Broward County, Florida, and her birth weight was in excess of 2500 grams. Brittany was delivered by George Edouard, M.D., who was, at all times material hereto, a participating physician in the Florida Birth-Related Neurological Injury Compensation Plan. The claim for benefits under the Florida Birth- Related Neurological Injury Compensation Plan filed on behalf of Brittany contends that she "suffered a neurological impairment to wit: Erb's Palsy to the left upper extremity at the time of birth." To support such contention, petitioner offered the testimony of Melvin Grossman, M.D., a board certified neurologist, who opined that Brittany suffered a left brachial plexus palsy, an Erb's palsy, and that the injury to the left brachial plexus that resulted in such palsy most likely occurred during the course of delivery. It was, however, Dr. Grossman's opinion that Brittany's mental functioning was age appropriate and not substantially impaired, and that the physical impairment she suffers (left Erb's palsy) is the consequence of an injury to her left brachial plexus, which is not a brain or spinal cord injury. Juxtaposed with the proof offered on behalf of petitioner, respondent offered the testimony of Michael Duchowny, M.D., who is board certified in pediatrics, neurology with special emphasis in child neurology, and clinical neurophysiology. It was Dr. Duchowny's opinion that the condition from which Brittany suffers was not caused in the course of labor, delivery, or resuscitation in the immediate post-delivery period in the hospital but, rather, was a consequence of congenital deformity. Dr. Duchowny concurs, however, that Brittany is not substantially mentally impaired, and that a brachial plexus injury, which can result in an Erb's palsy, is not an injury to the brain or spinal cord. Here, it is not necessary to resolve the conflict in the testimony, as to the cause of Brittany's injury, since the proof is uncontroverted that a brachial plexus injury, the cause of Erb's palsy, is not a brain or spinal cord injury. Moreover, it is uncontroverted that Brittany is not substantially mentally impaired. Under such circumstances, the proof fails to demonstrate that Brittany suffered an injury to the brain or spinal cord caused by oxygen deprivation or mechanical injury in the course of labor, delivery or resuscitation in the immediate post- delivery period, or that the injury Brittany did suffer rendered her permanently and substantially mentally and physically impaired.
The Issue At issue in this proceeding is whether Jenna Kemper, a minor, suffered an injury for which compensation should be awarded under the Florida Birth-Related Neurological Injury Compensation Plan.
Findings Of Fact Nancy Kemper and Jeffery Kemper are the parents and natural guardians of Jenna Kemper (Jenna), a minor. Jenna was born a live infant on March 27, 1996, at Lakeland Regional Medical Center, a hospital located in Lakeland, Polk County, Florida, and her birth weight was in excess of 2500 grams. The physician providing obstetrical services during the birth of Jenna was Keith Bernard Paredes, M.D., who was, at all times material hereto, a participating physician in the Florida Birth-Related Neurological Injury Compensation Plan (the Plan), as defined by Section 766.302(7), Florida Statutes. Jenna's delivery at Lakeland Regional Medical Center on March 27, 1996, was apparently difficult due to her large birth weight, and when delivered she was noted to have suffered an injury to her upper right brachial plexus, an Erb's palsy, which affected the range of motion on the upper right extremity, and is evidenced by diminished range of motion at the right elbow and an inability to freely elevate the right arm above neutrality at the shoulder. Jenna's brachio-plexus injury may reasonably be described as mild to moderate, and her impairment is most likely permanent. A brachial plexus injury, such as that suffered by Jenna during the course of her birth, is not, anatomically, a brain or spinal cord injury, and does not affect her mental abilities. Moreover, apart from the brachial plexus injury, Jenna was not shown to have suffered any other injury during the course of her birth. Consequently, the proof fails to demonstrate that Jenna suffered an injury to the brain or spinal cord caused by oxygen deprivation or mechanical injury during the course of labor or delivery, and further fails to demonstrate that she is presently permanently and substantially, mentally and physically impaired.
Findings Of Fact Bayron was born on September 26, 2017, at Winnie Palmer located in Orlando, Florida. Petitioner filed the Petition with DOAH on December 17, 2018. With the Petition, Petitioner produced certain medical records relevant to the claim. The medical records document that Bayron’s weight at birth was 2,241 grams. (Petitioner also attached Bayron’s birth certificate to the Petition. The birth certificate records Bayron’s birth weight at “4 LBS 15 OZ,” which equates to approximately 2,239.60 grams.) A review of the medical records submitted in this matter reveals no evidence disputing a finding that Bayron weighed under 2,500 grams at his birth. Based on the evidence that Bayron weighed less than 2,500 grams at birth, NICA determined that Petitioner’s claim was not compensable. NICA subsequently filed the Motion for Summary Final Order asserting that Bayron has not suffered a “birth- related neurological injury” as defined by section 766.302(2).
Conclusions Based upon the foregoing Findings of Fact and Conclusions of Law, it is ORDERED that the Petition is dismissed, with prejudice. DONE AND ORDERED this 4th day of September, 2019, in Tallahassee, Leon County, Florida. S J. BRUCE CULPEPPER 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 the Division of Administrative Hearings this 4th day of September, 2019. COPIES FURNISHED: (via certified mail) Kenney Shipley, Executive Director Florida Birth-Related Neurological Injury Compensation Association Suite 1 2360 Christopher Place Tallahassee, Florida 32308 (eServed) (Certified No. 7011 1570 0003 Valerie Ramos 4465 6037) Suite 304 5182 Millenia Boulevard Orlando, Florida 32839 (Certified No. 7011 1570 0003 4465 6044) Tana D. Storey, Esquire Rutledge Ecenia, P.A. Suite 202 119 South Monroe Street Tallahassee, Florida 32301 (eServed) (Certified No. 7011 1570 0003 4465 6051) Amie Rice, Investigation Manager Consumer Services Unit Department of Health 4052 Bald Cypress Way, Bin C-75 Tallahassee, Florida 32399-3275 (Certified No. 7011 1570 0003 4465 6068) Mary C. Mayhew, Secretary Health Quality Assurance Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 1 Tallahassee, Florida 32308 (eServed) (Certified No. 7011 1570 0003 4465 6075)
Other Judicial Opinions 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 agency clerk 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. 2d 299 (Fla. 1st DCA 1992).
