St. Vincent's Medical Center, Inc. v. Bennett

27 So. 3d 65, 2009 Fla. App. LEXIS 12744, 2009 WL 2602286
CourtDistrict Court of Appeal of Florida
DecidedAugust 21, 2009
Docket1D07-5557, 1D07-5561
StatusPublished
Cited by3 cases

This text of 27 So. 3d 65 (St. Vincent's Medical Center, Inc. v. Bennett) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St. Vincent's Medical Center, Inc. v. Bennett, 27 So. 3d 65, 2009 Fla. App. LEXIS 12744, 2009 WL 2602286 (Fla. Ct. App. 2009).

Opinions

VAN NORTWICK, J.

In these consolidated appeals, St. Vincent’s Medical Center, Inc., William H. Long, M.D., and North Florida Obstetrics and Gynecology, P.A., challenge a final order of the Division of Administrative Hearings (DOAH) in which the administrative law judge (ALJ) held that the child of Robert and Tammy Bennett, appellees, did not qualify for coverage by the Florida Birth-Related Neurological Injury Compensation Association (NICA). Because the ALJ erred as a matter of law in failing to apply the rebuttable presumption provided by section 766.309(l)(a), Florida Statutes (2001), we reverse and remand for further proceedings.

Factual and Procedural History

Tristan Bennett was born on September 26, 2001, at St. Vincent’s Hospital in Jacksonville. Her birth was preceded by an automobile accident that morning involving the infant’s mother. Following the accident, the mother was transported to a nearby hospital, Ed Fraser Memorial Hospital in MacClenny, Florida, where fetal testing was performed. The decision was made to transport the mother to St. Vincent’s via helicopter. That same day, after declining into kidney failure, the mother underwent a caesarean section. The condition of the infant at the time of her [67]*67delivery was a matter of controversy below. Although the infant required manual resuscitation, her Apgar scores at birth and within minutes of birth were in the normal range.1 It is undisputed, however, that the infant experienced renal distress as well as liver damage. She was placed in the special care nursery.

On October 3, 2001, while still in the special care nursery, the infant experienced pulmonary bleeding and then pulmonary arrest leading to multi-organ failure and seizure activity. She was later diagnosed with a neurological injury, cerebral palsy, although the time the neurological injury was sustained remains a matter of controversy. It was only after the October 3 episode that the infant was examined by a pediatric neurologist.

In 2006, the Bennetts filed suit in circuit court against their obstetrician, William H. Long, M.D., his professional association, St. Vincent’s, and fourteen other defendants. The circuit court proceedings were abated for a determination by DOAH as to whether the infant’s injuries were covered by the Florida Birth-Related Neurological Injury Compensation Plan (hereafter, the NICA Plan), section 766.301, et seq., Florida Statutes (2001). The Bennetts had already filed a petition with DOAH to determine compensation under the Plan. In their petition, the Bennetts described the child’s condition at birth as follows:

By the time of her birth by cesarean section, Tristan Bennett had suffered a hypoxic ischemic event that caused permanent brain damage. Tristan Bennett then suffered further injury to her brain during the first several days of life, well after the immediate post-delivery resus-citative period.

They argued in the petition that Dr. Long and St. Vincent’s could not claim NICA immunity because the Bennetts did not receive adequate notice of the NICA Plan. The trial court granted the motion for abatement.

At the administrative hearing, extensive medical records were introduced into evidence, although only two witnesses gave live testimony: the mother, Tammy Bennett, and Gary Hankins, M.D., a board certified obstetrician, who the record reflects has expertise in neonatal encephalopathy and cerebral palsy and whose practice specializes in high risk pregnancies. It was the appellants’ position, generally, that, after the accident but prior to and during the time of delivery, the infant suffered oxygen deprivation as a result of damage to the mother’s placenta and that the pH level, sodium level and blood gases of the infant just prior to and at the time of delivery supported the existence of such a condition. Appellants also asserted that the infant suffered multi-organ damage, as a result of the oxygen deprivation, which in turn caused the acute pulmonary arrest suffered several days later. Further, appellants argued that neurological injury occurred before or at delivery.

Below, appellants requested the ALJ to apply the presumption of compensability provided by section 766.309(l)(a), Florida Statutes. The ALJ refused to apply the presumption, ruling that the presumption is to be applied only for the benefit of claimants and is not available to other parties, such as the appellants.

[68]*68Following the hearing, the ALJ entered a final order which concluded in pertinent part:

41. The medical records, as well as the testimony of the physicians and other witnesses, have been thoroughly reviewed. Having done so, it must be resolved that the record developed in this case compels the conclusion that, more likely than not, Tristan suffered multi-system failure as a consequence of the oxygen deprivation she suffered between 12:47 p.m. (when the fetal monitor was disconnected and Mrs. Bennett was moved to the operating room) and 1:22 p.m. (when Tristan was delivered), that likely continued during the immediate postdelivery re-suscitative period. However, it is unlikely Tristan suffered a brain injury or substantial neurologic impairment until after she experienced profound episodes of oxygen deprivation on October 3, 2001, following the onset of pulmonary hemorrhaging and pulmonary arrest.
42. In so concluding, it is noted that Tristan was delivered atraumatically, she responded rapidly to resuscitation immediately after delivery, her neuro-logic examinations during the first seven days of life were normal, she suffered prolonged and severe decreases in fetal heart rate and saturations on October 3, 2001, she manifested prolonged and severe acidosis following her arrest, and she evidenced seizure activity and neu-rologic decline thereafter. Given the proof, it is likely, more so than not, that Tristan’s profound neurologic impairments resulted from a brain injury caused by oxygen deprivation that occurred October 3, 2001, and not during labor, delivery, or resuscitation in the immediate postdelivery period in the hospital. Consequently, Tristan was not shown to have suffered a “birth-related neurological injury” as defined by the Plan, and the claim is not compensable. § 766.302(2), Fla. Stat. See also Nagy v. Florida Birth-Related Neurological Injury Compensation Association, 813 So.2d 155, 160 (Fla. 4th DCA 2002) (“According to the plain meaning of the words written, the oxygen deprivation or mechanical injury must take place during labor and delivery, or immediately afterward.”).

(Bold added). Further, the ALJ found that the Bennetts received adequate notice.

Standard of Review

The standard of review of an ALJ’s interpretation of the NICA statutory scheme is de novo. Nagy v. Fla. Birth-Related Neurological Injury Comp. Ass’n, 813 So.2d 155, 159 (Fla. 4th DCA 2002). The ALJ’s determination with regard to the qualification of the claim for compensa-bility purposes under the statute is conclusive and binding as to all questions of fact. § 766.311(1), Fla. Stat. An ALJ’s final order is reversible on appeal, however, where its findings of fact are not supported by competent, substantial evidence. § 120.68(7) and (10), Fla. Stat.; see Nagy, 813 So.2d at 159; Carreras v. Fla. Birth-Related Neurological Injury Comp. Ass’n, 665 So.2d 1082, 1084 (Fla. 3d DCA 1995).

The Rebuttal Presumption under Section 766.309(l)(a)

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Related

Bennett v. St. Vincent's Medical Center, Inc.
71 So. 3d 828 (Supreme Court of Florida, 2011)
St. Vincent's Medical Center, Inc. v. Bennett
27 So. 3d 65 (District Court of Appeal of Florida, 2009)

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27 So. 3d 65, 2009 Fla. App. LEXIS 12744, 2009 WL 2602286, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-vincents-medical-center-inc-v-bennett-fladistctapp-2009.