The Issue The issues to be determined are whether the infant, Regina Singleton (Regina), suffered a birth-related neurological injury as that term is defined by section 766.302, Florida Statutes (2014), and whether Petitioner’s claim for compensation is barred by the application of section 766.313.
Findings Of Fact Regina was born on October 18, 2014, at Winnie Palmer Hospital. The Motion for Summary Final Order indicates that Regina’s medical records are attached to the Motion for Entry of Protective Order Regarding Confidential Documents Related to Petitioner’s Medical Records. There are no medical records attached to the Motion for Entry of Protective Order. Similarly, the Motion for Entry of Protective Order speaks in terms of confidential documents attached to the Motion for Summary Final Order. The only document attached is the Birth Certificate for Regina, which is also attached to the Petition. Notwithstanding that no medical records referenced in the Motion for Summary Final Order are actually attached, there is sufficient information in the birth certificate, which is provided and is already of record, to support the Motion for Summary Final Order. The birth certificate indicates that the infant’s weight at birth was five pounds, seven ounces, which is less than 2,500 grams. Petitioner has not disputed that Regina’s birth weight was below the 2,500-gram threshold established in section 766.302(2) for eligibility for NICA benefits.
Findings Of Fact A’Mayah Whatley was born on May 20, 2016, at St. Petersburg General Hospital in St. Petersburg, Florida. She was a single gestation. NICA attached to its motion a certification of medical records signed by the Custodian of Records from St. Petersburg General Hospital, and a one-page discharge record for A’Mayah. The medical record shows that A’Mayah’s birth weight was less than 2,500 grams. A review of the file reveals that no contrary evidence was presented to dispute the medical record from St. Petersburg General Hospital showing that A’Mayah’s birth weight was less than 2,500 grams.
Findings Of Fact Carmello Manuel-Edward Santiago was born on March 25, 2013, at Sacred Heart Hospital in Pensacola, Florida. He was a single gestation. Based on medical records from Sacred Heart Hospital, Carmello weighed 660 grams at birth. There is no dispute that Carmello did not weigh at least 2,500 grams at birth.
The Issue Whether Petitioners’ claim for compensation is time- barred pursuant to section 766.313, Florida Statutes. Whether Olivia Lowrey (Olivia), the minor child, has suffered a birth-related neurological injury as defined in section 766.302(2), compensable by the Florida Birth-Related Neurological Injury Compensation Plan (Plan).
Findings Of Fact Olivia was born at St. Joseph’s on November 23, 2010. The attending physician was Lorraine Bevilacqua, M.D., who was, at the time, a participating physician with the NICA Plan. Olivia weighed 2,820 grams at birth, or 6 pounds, 3.5 ounces. The medical records indicate that Ms. Lowrey was scheduled for a Cesarean section when she presented to the hospital in early labor. Medical staff prepped her for the Cesarean section upon arrival. According to the operative note, the Cesarean section delivery was complicated by existing adhesions, and discovery of an asymptomatic uterine rupture. The infant, which was noted to be a “viable female with Apgars of 4 and 9,” was delivered with the assistance of vacuum suction, and “suctioned. The cord was doubly clamped and cut, and the infant was taken to the awaiting nursing staff where the infant was easily resuscitated and responded well.” The Nurses Delivery Record indicates that at one minute, Olivia’s Apgar score2/ indicated she had an appropriate heart rate (2); slow, irregular respiratory effort (1); was limp (0); displayed a grimace (1); and was blue or pale in color (0), with a total score of four. At five minutes, her heart rate was fine (2); she exhibited a good cry in terms of respiration (2); had active motion (2); was crying (2), but still had blue extremities (1), for a total Apgar score of 9. Dr. Willis reviewed all of the medical records, both those that were supplied as exhibits to the Motion and those that were not. He indicated in his report that prior to delivery, the fetal heart rate monitor did not suggest fetal distress. The newborn evaluation noted hemorrhage in the left eye and icterus (jaundice). Routine care was initiated, and the records indicate no neonatal complications. There was no seizure activity during the newborn hospital stay, and no EEG or head imaging studies were performed at that time. Olivia’s parents assert that during delivery, the umbilical cord was wrapped around Olivia’s neck twice, despite the fact that the records do not mention this. They have attempted to get the hospital to correct the medical record with respect to this issue, but to no avail. Olivia’s parents are understandably distressed that the medical records do not reflect what they remember happening at Olivia’s birth, but what gave rise to the apparent discrepancies in the records is beyond the scope of this proceeding. Even if it is assumed, for the sake of this Order, that Mr. Lowrey witnessed the cord’s presence around Olivia’s neck, that event, without more, does not establish that the event led to a birth-related neurologic injury as that term is defined in section 766.302(2). Dr. Willis also noted that a CT scan of the brain was performed when Olivia was approximately six months old, and was “essential [sic] normal, describing only benign macronania.” He also noted that there was no documented fetal distress prior to delivery, and the baby did not suffer multi-system organ failure, which, according to Dr. Willis, is a common finding with birth-related oxygen deprivation. He opined, and his opinion is credited, that there was no apparent obstetrical event that resulted in oxygen deprivation or mechanical trauma to the brain or spinal cord during labor, delivery, or the immediate postdelivery period. Petitioners did not provide the expert opinion of a medical professional to rebut Dr. Willis’s opinion. Olivia is now approximately eight and a half years old. She has been diagnosed with ADHD, OCD, anxiety disorder, sleep disorder, and autism, and suffers from some sensory issues. The medical records indicate that she suffered mild developmental delays, and she has received therapy for a variety of concerns. However, the evidence does not demonstrate that as a result of a birth-related event, Olivia has suffered permanent and substantial physical and mental impairment. The Petition simply alleged that Olivia Lowrey “suffered brain damage as a result of a difficult birth.” There is no mention of what type of impairment resulted. NICA served Petitioners with interrogatories in response to their claim. Interrogatory number 7 asks: “Do you contend that OLIVIA LOWREY suffered mechanical injury during the course of labor, delivery or in the immediate post-delivery period? If so, please state whether you contend that such mechanical injury was suffered during labor, delivery, or in the immediate post-delivery period.” Petitioners answered, “My opinion is YES. We were never informed of mechanical vacuum assist during labor.” While the answer identifies a possible injury as occurring during labor, there is no indication provided (nor other evidence presented) to establish just what injury, if any, was caused by the use of the vacuum assist. Interrogatory number 9 asks, “Do you contend that OLIVIA LOWREY suffers from a permanent and substantial mental impairment?” Petitioners answer states that as a baby, Olivia was diagnosed as developmentally delayed, and that after multiple tests, she “has the following mental impairments: Autism, ADHD, sleep disorder, developmentally delayed, macrocephaly, encephalopathy.” Interrogatory number 11 asks, “Do you contend that OLIVIA LOWREY suffers from a permanent and substantial physical impairment? Petitioners’ response states, “[n]o, not physical - - mental, social, emotional, permanent and substantial deficits!” Petitioners provided a letter from a psychiatrist who cares for Olivia. Jeffrey Alvaro, M.D., a board-certified child, adolescent, and adult psychiatrist at Johns Hopkins All Children’s Hospital, authored the letter dated November 2, 2018, apparently for the purpose of establishing an IEP (individual education plan) for Olivia. Dr. Alvaro states: Olivia is a patient under my care at the Pediatric Psychiatry Clinic at Johns Hopkins All Children’s Hospital. She has been diagnosed with Autism Spectrum Disorder, ADHD, and Unspecified Anxiety Disorder. She has significant problems with inattention, impulsivity, hyperactivity, social skills, and anxiety that directly impair her learning process. Her diagnosis of Autism has been confirmed by ADOS testing. Though she is gifted, her other symptoms still cause significant issues in the classroom. She would benefit from extra time with testing, preferential seating, extra time at lunch, and extra breaks from class— especially when she is anxious. Please consider any other accommodations that are appropriate to help her manage the above symptoms. While Dr. Alvaro’s letter describes a litany of mental or cognitive impairments from which Olivia suffers, it does not describe any physical impairments, much less any physical impairments that rise to the level of being permanent and substantial. Petitioners also supplied a psychological evaluation from the University of South Florida, based upon testing dates of February 27, May 29, and June 12, 2018. The psychological evaluation notes that Olivia is in good health with no major medical concerns. It would have been helpful to have an opinion from either party as to whether Olivia’s issues rise to the level of a permanent and substantial mental and physical impairment. However, it appears from NICA’s pleadings that Olivia was scheduled for an evaluation, but did not appear for her appointment. The discovery responses received from Petitioners indicate that there is no physical impairment claimed. Petitioners have not provided an opinion from a physician (although they have provided records indicating a variety of medical appointments she has had) as to her current physical condition, or an opinion as to whether she suffers from permanent and substantial physical and mental impairments. In sum, NICA’s Motion and the attached exhibits demonstrate that there is no birth-related neurological injury resulting in permanent and substantial mental and physical impairments. The information provided by Petitioners in response to the motion does not create a dispute of material fact with respect to this issue.
Findings Of Fact Matthew Eugene McGrane was born on July 7, 2010, at Winnie Palmer Hospital for Women and Babies in Orlando, Florida. Based on his hospital records, Matthew weighed 1,415 grams at birth. He was a single gestation.
Findings Of Fact Fundamental findings Austin Robert Pollard (Austin) is the natural son of Ann S. and James A. Pollard. He was born a live infant on October 26, 1992, at Morton Plant Hospital, a hospital located in Clearwater, Pinellas County, Florida, and his birth weight was in excess of 2500 grams. The physician providing obstetrical services during the birth of Austin was Glenn A. Helwig, 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. Austin's birth and subsequent condition At or about 5:00 p.m., October 25, 1992, Ann S. Pollard's membranes spontaneously ruptured, and at or about 7:45 p.m. she was admitted to Morton Plant Hospital. At the time, Mrs. Pollard was at term, and her prenatal course had been uncomplicated, except for hyperemesis gravidarium (pernicious vomiting of pregnancy) and a history of genital herpes (herpes simplex virus), although no outbreaks were reported during the course of her pregnancy. Upon admission, a vaginal exam revealed dilation of the cervix at 1 centimeter, effacement at 80 percent, and the fetus at station -2. Fetal heart monitoring revealed a fetal heart tone of 130 to 140 beats per minute upon admission and, notably, no fetal distress was documented during the course of labor or delivery. 2/ Mrs. Pollard progressed slowly through labor during the evening, and at 5:00 a.m., October 26, 1992, the cervix was noted to be at 6 centimeters and the fetus at zero station. By approximately 8:00 a.m. the cervix progressed to 9 centimeters and the fetus to station +1, augmentation was begun at 9:30 a.m. with the use of pitocin, and by 1:10 p.m. dilation of the cervix was noted to be complete and the fetus at station +1. Following completion of the first stage of labor, pushing was started; however, Mrs. Pollard was not able to push well, even though the epidural anesthesia was decreased, and she experienced a prolonged second stage of labor. Consequently, at or about 3:40 p.m., Dr. Helwig determined to use forceps to deliver the child, and Mrs. Pollard was prepared for delivery. The medical records reveal that Austin was delivered vaginally at 3:47 p.m., October 26, 1992, with forceps and a moderate left medial lateral episiotomy that extended to the third degree. 3/ Upon delivery, Austin was observed to have the umbilical "cord around [his] neck and shoulder x 1"; however, he promptly breathed and cried with stimulation, and his Apgar scores were 7 at one minute and 9 at five minutes. The newborn record further reflects no abnormalities at birth, with the exception of bruising of the face and neck associated with the forceps delivery, and a "dusky" left great toe. Following delivery, Austin was placed in the nursery and his progress was unremarkable until 6:00 p.m. that day, when the infant progress notes reveal that the discoloration of the left foot, "lateral side 1/2 to and including great toe" had not changed, and that the "infant is moving foot and toe actively." Such observations were reported to Deborah French, M.D., and she referred for a neonatology consult. At or about 7:15 p.m. that day, a neonatology consult was had. That examination revealed: Baby Pollard is a 7 number 11 oz white male infant born by low forceps delivery to a 33 4.0 g2p0 0 pos mother @ EGA 39 wks. Prenatal care via Dr. Helwig beginning @ 6 wks EGA. Labs: STS n/r, Rubella immune, HBsAg neg, random glucose 74, Hepatitis profile negative (husband [with] possible exposure to Hepatitis C). Maternal history significant for: (1) H/O genital HSV - one outbreak several years ago, nothing during this pregnancy (2) Occasional ETOH, denies tobacco, drugs (3) Hyperemesis gravidarum Rx'd [with] diet, Tigan, Transdarm Scop. ROM 24h 47 min [at] delivery. No fetal distress documented. Low forceps delivery [with] Apgars 7 [at 1 minute] -9 [at 5 minutes] - rec'd 02 X 1 min for color. Shoulder/nuchal cord x 1 . . . Skin: No rash. Bruising over eyelids, earlobes. Forceps marks over face. HEENT: Molaing present. Ant. font. soft & flat. Eyelids edematous & bruised . . . RESP: Resp. easy [with] BBS cl & equal. Symmetrical chest rise. Becomes tachypreic [with] stimulation, but quickly resolves . . . Great toe of L foot, medial aspect of plantar/ dorsum deeply cyanotic - blanches under pressure - irregular borders . . . Neuro: Quiet - responds to stimuli [with] L lateral arching & draws R arm over abdomen. Otherwise good tone. + Moro, but quickly arches. + Grasp, suck. L foot cyanosis resolved somewhat when R foot wrapped [with] warm compress. Based on that examination the doctor gleaned the following impressions: IMP: Prolonged ROM - 24 3/4 h - R/O sepsis Cyanotic toe/foot - R/O arteriospasm, R/O embolus, R/O polycythemia, R/O hyperviscosity Arching [with] unusual posturing Consequently, the doctor recommended, among other things, admission to "SCN for monitoring," blood work, and a cranial ultrasound in the morning. The cranial ultrasound, taken October 27, 1992, revealed: . . . A VERY SMALL (4 X 3 MM) CYST IN THE ANTERIOR ASPECT OF THE CHOROID PLEXUS ON THE RIGHT SIDE. OTHERWISE, THE STUDY IS NEGATIVE. THE VENTRICLES APPEAR NORMAL AND SYMMETRIC BILATERALLY. THERE IS NO INTRACRANIAL HEMORRHAGE. IMPRESSION: . . . 1. SMALL CYST IN THE CHOROID PLEXUS OF THE RIGHT LATERAL VENTRICLE. SUGGEST REPEAT ULTRASOUND IN 3-4 WEEKS FOR COMPARISON. OTHERWISE, NEGATIVE STUDY. At or about 10:30 p.m., October 27, 1992, Austin was observed to evidence seizure activity that included rhythmic jerking of both feet and lip smacking, which lasted for 4 minutes. Over the next 9-10 hours, Austin had increased episodes of seizure activity, primarily right sided, and at or about 4:00 a.m., October 28, 1992, he was also observed to have developed a deeply cyanotic area of approximately 3 X 4 centimeters over the left scrotum, similar to the area initially involving the left toe. At or about 9:35 a.m., October 28, 1992, Austin was transferred to All Children's Hospital for further evaluation and care. There, Austin came under the care of Robert Kropp, M.D., a pediatric neurologist. While at All Children's Hospital, a CT scan of the brain was performed on October 28, 1992. It revealed "multifocal low-density, spherical lesions in both the supra- and infratentorial region without mass effect or hemorrhage." The radiologist observed that the "areas are fairly well defined and may represent areas of edema or developing encephalomalacia," and that he "[w]ould suspect some type of thromboembolic origin." Otherwise, the anatomy of the brain appeared normal. An EEG on the same date revealed multi focal epileptic abnormalities. Dr. Kropp's initial consultation of October 28, 1992, observed evidence of peripheral embolization, which was reflected by the blue discoloration found in the left great toe and in the scrotum area. He suspected that Austin had an anti-thrombin-3 deficiency which created the thromboembolic phenomenon to his leg and scrotum, and that diagnosis was supported by the multiple low density lesions observed on the CT scan which were also consistent with the thromboembolic phenomenon. Dr. Kropp's differential diagnosis was as follows: The differential diagnosis includes anti- thrombin 3 deficiency. The CT abnormalities are also consistent with congenital infection, such as CMV, HIV, or VDRL-positive spirochetes. It also suggests vasculitis, such as congenital lupus or intrauterine procaine exposure. These are secondary considerations in view of peripheral embolization, but need to be considered if the appropriate coagulin studies do not confirm the suspected primary diagnosis. While in All Children's Hospital, Austin was also evaluated by Robert A. Good, M.D., the head of the hospital's division of clinical immunology and allergy. His consultation of November 5, 1992, observed: Hematology evaluated this patient and felt that the thromboembolic manifestations might be secondary to deficiency of anticoagulant proteins. This patient's antithrombin 3 was within normal limits, as well as PT, PTT, and fibrinogen. . . . His impressions were: This thromboembolic phenomenon may be seen with neonatal lupus. In many cases, sometimes the mother is unaware of her lupus and the manifestation in the infant leads to the diagnosis. Would recommend anti-Ro and anti-La, which are associated with infantile lupus. Would also obtain an anti-double-stranded DNA, as well as an ANA in the infant. Would perform an EKG to rule out a congenital heart block. It is also important to obtain anti-cardiolipin antibodies in the mother, as well as circulating lupus anticoagulants. The performance of a skin biopsy to rule out vasculitis is not useful. Another entity that may be considered is HIV infection, acquired early in gestation, which may certainly present as a thromboembolic phenomenon. To work this up, we suggest HIV ELISA, as well as PCR P24 antigen, and HIV culture. Other entities which have also been considered are congenitally-acquired viral infections, such as syphilis and herpes, or CMV. Would also consider leptospirosis. Austin was discharged from All Children's Hospital on November 13, 1992, to his parents' care. The diagnosis on discharge was seizures and peripheral thrombo embolization. The discharge summary further observed: INFECTIONS: Blood culture was done at the referring hospital. CBC was within normal limits. The infant was started on Ampicillin and Gentamicin. An LP was performed. CSF and viral cultures were obtained. All cultures were negative. The anti- biotics were discontinued after 7 days. There was a maternal history of herpes in the past although no outbreaks were reported during this pregnancy. NP and eye viral cultures were negative for herpes. Stool for echovirus and enterovirus were also negative. TORCH IgMs were obtained from the referring hospital and were reported as negative. On day 9 an Immunology consult was requested to rule out a vasculitis. Infantile lupus work up on the infant was negative. Maternal PT, PTT, protein, C&S, and lupus anticoagulant were all negative. Paternal PT, PTT, protein, C&S were normal. * * * HEMATOLOGY: Due to the peripheral thromboembolic manifestations a Hematology consult was obtained. The infant was evaluated for a deficiency of anticoagulant proteins. The infant was started on daily FFP administration. The antithrombin 3, FSP, PT, PTT, and fibrinogen were all within normal. Proteins S and C were normal. Urine amino acids are pending. FFP administration was discontinued on day 15 when the proteins S&C were reported normal. The infant was closely observed and there was no reoccurrence of cyanosis or thrombosis noted. The infant's mother was instructed to call a physician if cyanosis or purpura was seen. The infant will be followed by Dr. Bagtas in 2 weeks. The etiology for the suspected thromboembolic event is unknown at this time. * * * CENTRAL NERVOUS SYSTEM; Due to the seizure activity a cranial ultrasound was done at the referral hospital at 1 day of age and was normal except for a small right choroid cyst. Due to seizures a CT of the brain was performed at 2 days of age at All Children's. This revealed multifocal low density spherical lesions in both supra and infra tentorial region without mass effect or hemorrhage. This may represent edema or encephalomalacia of thromboembolic origin. An EEG, completed on the same date, revealed multifocal epileptic form abnormalities. These seizures were controlled with Phenobarbital. . . . As of the date of discharge, the etiology or cause for the suspected thromboembolic event was unknown. The cause and timing of Austin's neurologic insult. Here, the proof demonstrates, more likely than not, that the deficits Austin suffers, discussed infra, were the consequence of a spontaneous left thalamic hemorrhage, generically referred to as a stroke in these proceedings, which occurred subsequent to birth, but during the first 48 hours of life. Consequently, the injury Austin suffered to his brain occurred during the neonatal period, which is defined as the time period subsequent to birth and through the first 30 days of life, as opposed to occurring during labor, delivery or the immediate post-delivery period. As for the cause of Austin's stroke, the objective evidence, as reflected by the blue discoloration found in his left great toe and in the scrotum area, as well as the multiple low density lesions observed on the CT scan, is consistent with a thromboembolic phenomenon, a hematologic phenomenon, as opposed to oxygen deprivation or mechanical injury suffered during the course of labor, delivery or the immediate post-delivery period. Consequently, while the underlying cause for the hematologic phenomenon which precipitated Austin's stroke has not been definitively established, it must be concluded that, based on the record developed in this case, the injury he sustained was unrelated to the actual birthing process. In concluding that the proof fails to demonstrate that Austin's neurologic insult was occasioned by oxygen deprivation or mechanical injury during the birthing process, it is first observed that the competent medical testimony does not suggest that Austin suffered any fetal distress, occasioned by oxygen deprivation or mechanical injury, during the course of labor or delivery which would have resulted in the subject injury but, rather, points to a hematologic phenomenon as the origin of Austin's stroke. That testimony is consistent with the medical records which, facially, did not reflect fetal distress during labor or delivery, the fact that following delivery Austin was suctioned and received whiffs of oxygen for color but was not intubated nor ventilated, that upon delivery Austin's Apgar scores were 7 and 9, which is not indicative of perinatal distress, and the consistency of the objective evidence regarding his subsequent condition with a hematologic phenomenon as the cause of his distress. Finally, although the use of forceps to deliver Austin did cause some bruising in or about the facial area, no physician who testified in this case suggested such injury caused or contributed to Austin's neurologic insult. To the contrary, the testimony demonstrated that the discoloration on the great left toe and scrotum area, as well as the cerebral infarcts, were unrelated to the use of forceps. 4/ Austin's mental and physical condition Austin has undergone two developmental evaluations through All Childrens' Hospital. The first took place on October 18, 1993, when Austin was 11 months, twenty-two days old. The evaluation revealed that he had cognitive development to an age equivalent level of 10 months, motor development to an age equivalent of 8.9 months, and communication development to an age equivalent level of 10.5 months. Such scores reflected that Austin's "cognitive skills [were] delayed for his chronological age," his motor development was "below age-appropriate for his chronological age, primarily due to slightly abnormal muscle tone in his trunk and extremities," but that he "present[ed] with communication skills that [were] within a range of normal limits for his age." He was referred to a developmental preschool, as well as for occupation and physical therapy. No speech therapy was recommended. The second developmental evaluation took place on June 20, 1994, and June 22, 1994, when Austin was approximately 20 months old. The evaluation revealed that he had cognitive development to an age equivalent level of 16 months, motor development to an age equivalent level of 17 months, and communication development to an age equivalent level of 18 months (receptive) and 17.25 months (expressive). Such scores revealed that Austin's cognitive skills continued to be delayed for his chronological age, that his motor development (gross and fine) was below age-appropriate for his chronological age, and that his communication skills were "suspect . . . [when evaluated because he] presented as shy and quiet for the majority of the evaluation; therefore, information was obtained via parent report." Austin has continued to be followed by Dr. Robert Kropp, as his primary pediatric neurologist, since his first admission to All Children's Hospital. In the opinion of Dr. Kropp, which is credited, Austin has been set back mentally and physically "from what would be described as normal development as it relates to a child of his age" due to complications from the stroke he suffered and resulting seizures. [Petitioners' exhibit 19, page 25]. As for Austin's physical condition, Dr. Kropp observed that he had a residual right sided weakness, which the doctor ascribed as the cause of Austin's internally rotated left foot, and a tendency for the right arm to posture when Austin ran. Consequently, Austin had difficulty climbing, as well as turning and negotiating uneven surfaces. Austin also evidenced a balance problem, and tremors bilaterally, with the right worse than the left. To address his balance and coordination problem, Dr. Kropp prescribed Amantadine, which alters the biochemical functioning of the cerebellum, the balance organ of the brain. By observation, Austin's balance and coordination improved on the medication compared to off the medication. As for Austin's mental condition, Dr. Kropp did not elaborate beyond his conclusion that Austin's mental development was not age- appropriate. Concerning the significance and permanency of Austin's physical and mental delays, Dr. Kropp was of the opinion, as evidenced by his last consult of October 11, 1994, that Austin's developmental delays were very moderate and improving. Such conclusion is consistent with the opinion of Michael S. Duchowny, M.D., who examined Austin on March 2, 1995, and concluded: . . . Austin has evidence of a very mild residual asymmetry of motor postures primarily evidenced in the right arm. There is no evidence of spasticity. I believe that the internal rotation of the left lower extremity is more likely to be orthopedic in origin, possibly related to his hip joint. Certainly it does not fit with his past history of possible left hemisphere damage. I thing that his social and cognitive skills are quite good and the future prognosis would appear promising. Notably, among neurologists, mental and physical impairments are routinely classified as mild, moderate or severe. Here, Austin's developmental delays have been classified as "very moderate," a classification far below what would be considered severe.
The Issue The issue to be determined is whether the infant, Cory M. Irvin (Cory), suffered a birth-related neurological injury as that term is defined by section 766.302, Florida Statutes (2016).
Findings Of Fact On July 10, 2016, Coral Perdomo gave birth to a baby boy named Cory. Both the Amended Petition and the Discharge Summary from Winnie Palmer list Cory’s birth weight as 1,552 grams.
