Central Va. Obstetrics,et al v. Lawanda P. Whitfiel ( 2004 )


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  •                               COURT OF APPEALS OF VIRGINIA
    Present: Judges Humphreys, Felton and Kelsey
    Argued at Salem, Virginia
    CENTRAL VIRGINIA OBSTETRICS &
    GYNECOLOGY ASSOCIATES, P.C., AND
    KWASI A. DEBRA, M.D.
    v.             Record No. 0399-03-2
    LAWANDA P. WHITFIELD, Administratrix of                                    OPINION BY
    the ESTATE OF DEJUAN L. WHITFIELD-SMITH                             JUDGE D. ARTHUR KELSEY
    JANUARY 13, 2004
    CHIPPENHAM & JOHNSTON-WILLIS HOSPITAL, INC.
    v.             Record No. 0400-03-2
    VIRGINIA BIRTH-RELATED NEUROLOGICAL
    INJURY COMPENSATION PROGRAM
    FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION
    Kathleen M. McCauley; Linda B. Georgiadis; (Michael L. Goodman;
    Anthony Tacconi; Matthew D. Joss; Goodman, Allen & Filetti, PLLC;
    LeClair Ryan, on briefs), for appellants.
    William C. Carr, Jr. (Emroch & Kilduff, L.L.P., on brief), for appellee
    Lawanda P. Whitfield, Administratrix of the Estate of Dejuan L.
    Whitfield-Smith, Deceased.
    Scott John Fitzgerald, Assistant Attorney General (Jerry W. Kilgore,
    Attorney General; Judith Williams Jagdmann, Deputy Attorney General;
    Edward M. Macon, Senior Assistant Attorney General, on brief), for
    appellee Virginia Birth-Related Neurological Injury Compensation
    Program.
    Dejuan Whitfield-Smith died within a couple of hours after his birth. His estate filed a
    malpractice action in Richmond Circuit Court against Chippenham & Johnston-Willis Hospital,
    Inc., Central Virginia Obstetrics & Gynecology Associates, P.C., and Kwasi A. Debra, M.D. In
    defense of this claim, the defendants asserted statutory tort immunity under the Virginia
    Birth-Related Neurological Injury Compensation Act, Code §§ 38.2-5000 to 38.2-5021. As the Act
    requires, the circuit court referred the question to the Virginia Workers’ Compensation
    Commission. After hearing conflicting medical evidence, the commission held that the Act did not
    apply to Dejuan’s injury and thus did not afford statutory immunity to the tort defendants. The
    defendants, appellants in this consolidated appeal, seek our review of the commission’s decision.
    They contend that the commission misapplied the burden of proof and made insupportable factual
    findings. Disagreeing with both contentions, we affirm.
    I.
    On appeal, we view the evidence in the light most favorable to the prevailing party before
    the commission. Clinchfield Coal Co. v. Reed, 
    40 Va. App. 69
    , 72, 
    577 S.E.2d 538
    , 539 (2003);
    Tomes v. James City (County Of) Fire, 
    39 Va. App. 424
    , 429, 
    573 S.E.2d 312
    , 315 (2002).
    Lawanda Whitfield gave birth to an infant son, Dejuan Whitfield-Smith, at Chippenham
    Medical Center on December 30, 1998. Dr. Kwasi Debra, an obstetrician, used forceps extraction
    during the delivery. When Dejuan emerged from the birth canal, his nuchal cord was wrapped
    tightly around his neck.
    After being cut free, Dejuan remained in severe respiratory distress. His Apgar scores were
    1 at one minute, 0 at five minutes, and 0 at ten minutes.1 Dr. Debra pronounced Dejuan dead in the
    delivery room and handed him over to his mother. Dejuan’s mother noticed, however, that he
    appeared to be gasping for breath. A nurse also noted that Dejuan was moving his arms and legs.
    1
    The Apgar rating scale ranges from 1 to 10. It provides a numerical expression of a
    newborn’s condition that assesses heart rate, respiratory effort, muscle tone, reflex, irritability,
    and color. See generally Gaalaas v. Morrison, 
    233 Va. 148
    , 150 n.2, 
    353 S.E.2d 898
    , 899 n.2
    (1987); Rutherford v. Zearfoss, 
    221 Va. 685
    , 687, 
    272 S.E.2d 225
    , 226 (1980).
    -2-
    She took the child’s pulse and discovered he had a heart rate in the 150s. An intensive care team
    took Dejuan to the Neonatal Intensive Care Unit. Dejuan’s condition quickly deteriorated. He was,
    again, pronounced dead about two hours later.
    Dr. Fabio Gutierrez performed an autopsy and concluded that the cause of Dejuan’s death
    was cardiopulmonary arrest secondary to birth asphyxia as a result of being choked by his umbilical
    cord during labor and delivery. Dejuan’s mother, as administratrix of her son’s estate, filed a
    wrongful death action in circuit court against Dr. Debra, her medical practice, and the hospital.
    Asserting that Dejuan’s injury fell within the scope of the Virginia Birth-Related Neurological
    Injury Compensation Act, the defendants sought the statutory tort immunity afforded under the Act.
    Pursuant to Code § 8.01-273.1, the trial court referred the question to the commission.
    Before the commission, the parties submitted conflicting medical evidence on the newborn’s
    precise condition prior to his death. This evidence, the defendants argued, triggered a statutory
    presumption that the Act governed Dejuan’s injury. The commission disagreed, finding the
    evidence insufficient to invoke the presumption.
    Dr. Debra, her medical practice, and the hospital appeal the commission’s ruling to us
    claiming (a) the commission failed to properly apply the Act’s statutory presumption and thereby
    misallocated the burden of proof, and (b) had the presumption been applied properly, it would have
    established the Act’s coverage. After reviewing the history and purposes of the Act, we will
    address each of the appellants’ arguments in turn. In our judgment, neither has merit.
    II.
    One of only two such statutes in the nation, the Virginia Birth-Related Neurological
    Compensation Act provides claimants with a no-fault remedy for compensation for qualified
    -3-
    injuries. See Code § 38.2-5009.2 The Act also affords potential tort defendants (at least those
    who contribute voluntary assessments to the fund under Code § 38.2-5015), with an absolute
    immunity to civil malpractice liability for these injuries. See Code § 38.2-5002(B). “The Act
    generally provides the sole remedy for infants who have incurred a birth-related neurological
    injury caused by a ‘participating physician’ or a ‘participating hospital,’ and bars infants who
    have sustained injuries of this nature from maintaining a common law tort action against such a
    ‘participating physician’ or ‘participating hospital.’” Berner v. Mills, 
    265 Va. 408
    , 411, 
    579 S.E.2d 159
    , 160 (2003).
    This finely engineered quid pro quo, however, does not uniformly favor claimants or
    potential tort defendants. In cases where malpractice litigation appears ill advised, a claimant
    may seek the application of the Act to his claim to obtain benefits from the statutory
    compensation fund. See Code §§ 38.2-5009, 38.2-5015(A). But in cases where litigation may
    be more promising, a claimant may seek to defeat the application of the Act to his claim. Each
    of our cases discussing the Act involves instances where claimants sought the application of the
    Act to their claims and were willing to stipulate the resulting tort immunity afforded to potential
    malpractice defendants.3 The case before us now, however, involves one of the second type: a
    situation where the tort defendants in a pending malpractice lawsuit seek the application of the
    Act to the claim over the objection of the claimant.
    2
    See generally The Definition of Compensable Injury and the Funding Mechanism of the
    Virginia Birth-Related Neurological Injury Compensation Act, House Doc. No. 63 (1990); see
    also Study to Increase the Scope and Magnitude of the Virginia Birth-Related Neurological
    Injury Compensation Program, House Doc. No. 58 (1998).
    3
    Wolfe v. Va. Birth-Related Neuro. Injury Comp. Pgm., 
    40 Va. App. 565
    , 580, 
    580 S.E.2d 467
    , 474 (2003); Kidder v. Va. Birth-Related Neuro. Injury Comp. Pgm., 
    37 Va. App. 764
    , 778, 
    560 S.E.2d 907
    , 913 (2002); Coffey v. Va. Birth-Related Neuro. Injury Comp. Pgm.,
    
    37 Va. App. 390
    , 401-02, 
    558 S.E.2d 563
    , 569 (2002); Va. Birth-Related Neuro. Injury Comp.
    Pgm. v. Young, 
    34 Va. App. 306
    , 318, 
    541 S.E.2d 298
    , 304 (2001).
    -4-
    For the Act to apply, the infant must have suffered a “birth-related neurological injury.”
    See Coffey v. Va. Birth-Related Neuro. Injury Comp. Pgm., 
    37 Va. App. 390
    , 399-400, 
    558 S.E.2d 563
    , 568 (2002). Under Code § 38.2-5001, four things must be true for an injury to fit
    this definition:
    (1)     The infant sustained “an injury to the brain or spinal cord” that was
    “caused by deprivation of oxygen or mechanical injury.”
    (2)     The injury occurred “in the course of labor, delivery or resuscitation
    necessitated by a deprivation of oxygen or mechanical injury that
    occurred in the course of labor or delivery, in a hospital.”
    (3)     The injury rendered the infant “permanently motorically disabled and
    (i) developmentally disabled or (ii) for infants sufficiently developed
    to be cognitively evaluated, cognitively disabled.”
    (4)     Such disability caused “the infant to be permanently in need of
    assistance in all activities of daily living.”4
    4
    The full text of the statutory definition in Code § 38.2-5001 states:
    “Birth-related neurological injury” means injury to the brain or
    spinal cord of an infant caused by the deprivation of oxygen or
    mechanical injury occurring in the course of labor, delivery or
    resuscitation necessitated by a deprivation of oxygen or
    mechanical injury that occurred in the course of labor or delivery,
    in a hospital which renders the infant permanently motorically
    disabled and (i) developmentally disabled or (ii) for infants
    sufficiently developed to be cognitively evaluated, cognitively
    disabled. In order to constitute a “birth-related neurological
    injury” within the meaning of this chapter, such disability shall
    cause the infant to be permanently in need of assistance in all
    activities of daily living. This definition shall apply to live births
    only and shall not include disability or death caused by genetic or
    congenital abnormality, degenerative neurological disease, or
    maternal substance abuse. The definition provided here shall apply
    retroactively to any child born on and after January 1, 1988, who
    suffers from an injury to the brain or spinal cord caused by the
    deprivation of oxygen or mechanical injury occurring in the course
    of labor, delivery or resuscitation in the immediate postdelivery
    period in a hospital.
    -5-
    If the party seeking the Act’s application proves that the injury falls within this definition, the
    Act applies. The result is the potential availability of compensation to the claimants under Code
    § 38.2-5009 and the certain availability of tort immunity for any potential tort defendants under
    Code § 38.2-5002(B).
    Under the Act, a rebuttable presumption of a birth-related neurological injury exists when
    the proponent of the Act’s coverage proves elements one and three of the § 38.2-5001 definition.
    See Code § 38.2-5008(A)(1)(a). When these two predicate facts are proved, the factfinder may
    presume that elements two and four of the statutory definition are also met.5 Once the
    presumption applies, the burden of proof shifts to the party opposing the presumption to disprove
    elements two and four, and thereby establish “that the injuries alleged are not birth-related
    neurological injuries within the meaning of the chapter.” Wolfe v. Va. Birth-Related Neuro.
    5
    Code § 38.2-5008(A)(1)(a) provides:
    The Commission shall determine, on the basis of the evidence
    presented to it, the following issues:
    1.      Whether the injury claimed is a birth-related neurological
    injury as defined in § 38.2-5001.
    a.     A rebuttable presumption shall arise that the injury
    alleged is a birth-related neurological injury where
    it has been demonstrated, to the satisfaction of the
    Virginia Workers’ Compensation Commission, 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 motorically disabled and (i)
    developmentally disabled or (ii) for infants
    sufficiently developed to be cognitively evaluated,
    cognitively disabled.
    If either party disagrees with such presumption, that
    party shall have the burden of proving that the
    injuries alleged are not birth-related neurological
    injuries within the meaning of the chapter.
    -6-
    Injury Comp. Pgm., 
    40 Va. App. 565
    , 578, 
    580 S.E.2d 467
    , 474 (2003) (quoting Code
    § 38.2-5008(A)(1)(a)).6
    A.
    In this case, the parties agree that Dejuan suffered “an injury to the brain or spinal cord”
    caused by the “deprivation of oxygen or mechanical injury” — element one of the statutory
    definition and the first predicate fact necessary for the presumption. They also agree that
    Dejuan’s injury occurred “in the course of labor, delivery or resuscitation necessitated by a
    deprivation of oxygen or mechanical injury that occurred in the course of labor or delivery, in a
    hospital” — element two of the definition and a fact that may be inferred if the presumption
    applies. The parties dispute whether Dejuan’s injury caused him to be “permanently in need of
    assistance in all activities of daily living,” but admit that this fact may be inferred if the statutory
    presumption applies.
    The dispositive issue thus centers on whether appellants established that Dejuan, prior to
    his death, was permanently “motorically disabled” and “developmentally” or “cognitively”
    disabled — the second predicate fact necessary for the § 38.2-5008(A)(1)(a) presumption to
    apply. To resolve this dispute, we must first address appellants’ argument that a predicate fact
    can be established merely by “the submission of any credible evidence.” Under this view, the
    presentation of any plausible evidence (regardless of whether it is in fact believed) triggers the
    presumption and shifts the burden of persuasion to the other side to rebut it. After all, appellants
    6
    Because of the “difficulty in proving when such an injury was sustained” and the
    equally difficult task of proving, prospectively, that the infant will permanently need assistance
    in all activities of daily living, “the legislature enacted a presumption to assist potential claimants
    in obtaining benefits.” Coffey, 37 Va. App. at 400, 
    558 S.E.2d at 568
    . Despite Coffey’s
    contextualization of the issue, however, the presumption also applies in cases where the claimant
    is not seeking assistance in obtaining statutory benefits, but rather is seeking to defeat the
    application of the Act and its resulting tort immunity. In such circumstances, the medical
    providers who seek the Act’s application to the claimant’s injury bear the burden of proof.
    -7-
    correctly point out, we have described the burden as merely “a prima facie” showing, Coffey, 37
    Va. App. at 401, 
    558 S.E.2d at 569
    , which literally means “at first sight” or “on first
    appearance,” Black’s Law Dictionary 1209 (7th ed. 1999). That description, as a general rule,
    does not connote anything more than a mere evidentiary sufficiency. See, e.g., Virginia v. Black,
    538 U.S. __, 
    123 S. Ct. 1536
    , 1554 (2003) (Scalia, J., concurring in part) (“‘Prima facie evidence
    of a fact is such evidence as, in judgment of law, is sufficient to establish the fact; and, if not
    rebutted, remains sufficient for the purpose.’” (quoting 7B Michie’s Jurisprudence of Virginia
    and West Virginia § 32 (1998)). “Prima facie evidence is evidence which on its first appearance
    is sufficient to raise a presumption of fact or establish the fact in question unless rebutted.”
    Commonwealth v. Dalton, 
    11 Va. App. 620
    , 623, 
    400 S.E.2d 801
    , 803 (1991) (quoting Babbitt v.
    Miller, 
    192 Va. 372
    , 379-80, 
    64 S.E.2d 718
    , 722 (1951)).7
    Even so, the expression “prima facie showing,” Coffey, 
    37 Va. App. at 401
    , 
    558 S.E.2d at 569
    , need not necessarily be understood to describe a mere hypothetical sufficiency of the
    evidence. Though uncommon, this expression has been used alongside an actual preponderance
    standard for purposes of triggering a presumption. In Title VII cases, for example, the United
    States Supreme Court describes the role of a “prima facie case” in just this way:
    The burden of establishing a prima facie case of disparate
    treatment is not onerous. The plaintiff must prove by a
    preponderance of the evidence that she applied for an available
    position for which she was qualified, but was rejected [all
    7
    When a trial judge in a civil jury case, for example, entertains a motion to strike
    alleging that the plaintiff has not made out a prima facie case, the judge does not ask whether he
    personally believes that the evidence rises to a preponderance — rather, he asks whether the
    conclusion the plaintiff draws from the evidence would so “defy logic and common sense” that
    no rational factfinder could adopt it. Upper Occoquan Sewage Auth. v. Blake Constr., 
    266 Va. 582
    , 590 n.6, 
    587 S.E.2d 721
    , 725 n.6 (2003); see generally W. Hamilton Bryson, Virginia Civil
    Procedure 447 (3d ed. 1997).
    -8-
    predicate facts] under the circumstances which give rise to an
    inference of unlawful discrimination [the presumed fact].
    Texas Dept. of Cmty. Affairs v. Burdine, 
    450 U.S. 248
    , 253 (1981) (emphasis added); see also
    McDonnell Douglas Corp v. Green, 
    411 U.S. 792
    , 802 (1973) (holding that claimant triggers the
    presumption by carrying “the initial burden under the statute of establishing a prima facie case of
    racial discrimination”); cf. Wolfe, 
    40 Va. App. at 580
    , 
    580 S.E.2d at 474
     (accepting, without
    discussion, that a “preponderance of the evidence” standard applies to the § 38.2-5008(A)(1)
    presumption). This description of a prima facie case requires the factfinder to subjectively
    believe the evidence preponderates in the claimant’s favor, not merely to conclude that an
    objective, rational factfinder could so find.
    The subtle distinction between these two competing views of a prima facie case, while
    seeming semantic, understates its potentially outcome-determinative impact. This is particularly
    true in cases where, as here, the dispute involves not so much a contest between two
    contradictory sets of facts, but rather a scramble over how to interpret the paucity of facts
    favoring either side. In such cases, the party with the ultimate burden of proof must demonstrate
    not only that his view of the evidence should be adopted with confidence, but also that any view
    of such sketchy evidence could be confidently adopted.
    We do not answer appellants’ argument, however, by weighing the competing policy
    considerations underlying the assignment of the shifting burdens of proof to determine which
    would best fit this case. Our task is considerably more simple. “We begin, as always, with the
    language of the statute.” Duncan v. Walker, 
    533 U.S. 167
    , 172 (2001). And we strive to give
    that language a “literal construction” unless doing so “would involve a manifest absurdity.”
    Chase v. DaimlerChrysler Corp., 
    266 Va. 544
    , 547, 
    587 S.E.2d 521
    , 522 (2003) (citations
    omitted); see also Mouberry v. Commonwealth, 
    39 Va. App. 576
    , 583, 
    575 S.E.2d 567
    , 570
    (2003) (recognizing that statutory words should be given “their common, ordinary and accepted
    -9-
    meaning”). This textualist approach presumes that the legislature “‘chose, with care,’ the
    specific words of the statute.” Kane v. Szymczak, 
    41 Va. App. 365
    , 371, 
    585 S.E.2d 349
    ,
    352-53 (2003) (citations omitted).
    In this case, the Virginia Birth-Related Neurological Injury Compensation Act states that
    the presumption arises when the predicate facts have been “demonstrated, to the satisfaction of
    the Virginia Workers’ Compensation Commission.” Code § 38.2-5008(A)(1)(a) (emphasis
    added). To demonstrate a fact to the satisfaction of the factfinder means to persuade the actual
    factfinder, not merely to demonstrate the plausibility of the proffered fact to a sufficient degree
    that any rational factfinder could be persuaded. Relying on this statutory text, we reject
    appellants’ argument that “the submission of any credible evidence” triggers the presumption.
    Instead, we hold that the party asserting the presumption must demonstrate by a preponderance
    of the evidence that the predicate facts are true. Only then does the presumption arise and the
    burden of proof shift to the party opposing the presumption.
    B.
    We next address appellants’ assertion that the commission erred in holding that they did
    not prove by a preponderance that Dejuan was permanently “motorically disabled” and
    “developmentally” or “cognitively” disabled, the second predicate fact necessary to give rise to
    the § 38.2-5008(A)(1)(a) presumption. For the following reasons, we conclude that the
    commission acted within the scope of its decisionmaking discretion as factfinder.
    Appellants produced the expert opinions of Dr. Edward Karotkin and Dr. Warren
    Broocker. In a letter opinion, Dr. Karotkin concluded that “[e]ven if the child had responded to
    the resuscitative efforts, due to the profound oxygen deprivation to his brain, he would have been
    rendered permanently motorically disabled, developmentally disabled, and cognitively disabled.”
    Testifying before the deputy commissioner, Dr. Broocker stated that “usually when the asphyxia
    - 10 -
    is severe enough to cause Apgar scores” as low as Dejuan’s, “the long-term neurologic condition
    of the baby will be affected. To what degree it will be affected varies from individual to
    individual, but it will be affected.” Dr. Broocker admitted some doubt, however, as to the
    accuracy of Apgar scores in predicting future neurological deficits. These scores have been used
    “pretty glibly over the years as medical fact,” Dr. Broocker observed, and “there are some
    problems with the Apgar scores actually really predicting as far as how well the baby will do
    neurologically later on.” He also noted that “everybody’s got an anecdotal case of an extremely
    poor Apgar score and the baby did well subsequently . . . .”
    Dejuan’s estate filed the report of Dr. David Axelrod who stated that, given the paucity of
    medical evidence available to make such a judgment, he did not “believe that anyone” could
    make the determination whether Dejuan “would have been permanently motorically disabled and
    developmentally disabled had he survived.” Based upon his review of the child’s autopsy,
    “which showed no pathological damage to the brain such as bleeding, or signs of necrosis,” there
    was “no evidence that this baby would have been permanently motorically disabled and
    developmentally disabled if he had survived.”
    The commission, pursuant to Code § 38.2-5008(C), solicited a report from a panel of
    three impartial physicians. In a letter dated November 29, 2001, Dr. William N.P. Herbert,
    Dr. James E. Ferguson, II, and Dr. Barbara Head stated: “Given the fact that this infant expired
    approximately 2 1/2 hours following delivery, we are unable to determine that the infant was
    developmentally or cognitively disabled, nor can we state that the infant would be permanently
    in need of assistance in all activities of daily living.” As a result, they concluded, “the evidence
    in this case does not meet the criteria” for a birth-related neurological injury under the Act.
    Faced with this evidence, the commission found that appellants failed to prove Dejuan
    was permanently motorically disabled and developmentally or cognitively disabled. The
    - 11 -
    commission rejected Dr. Karotkin’s opinion because there was “no evidence to quantify the
    amount of oxygen deprivation suffered by the infant . . . , no damage to the brain, such as
    intracranial bleeding or any other pathology” in the autopsy report and “no blood from the cord
    was obtained for testing.” Equally unconvincing to the commission was Dr. Broocker’s opinion,
    which “offered no opinion as to whether the infant would have been developmentally disabled.”
    Finding more persuasive the opinions of Dr. Axlerod and the three independent panel physicians,
    the commission held that appellants failed to prove that Dejuan was permanently “motorically
    disabled” and “developmentally” or “cognitively” disabled. Appellants, therefore, failed to
    trigger the presumption and thereby shift the ultimate burden of proof.
    We are in no position to disagree. Of the six physicians that reviewed the file, four stated
    that they could not “determine that the infant was developmentally or cognitively disabled” at the
    time of his death. Three of these four physicians were independent experts appointed by the
    commission. Only one physician stated unequivocally that Dejuan was permanently motorically
    disabled and developmentally or cognitively disabled — and the commission found this opinion
    unpersuasive given the lack of any reliable diagnostic evidence.
    “Questions raised by conflicting medical opinions must be decided by the commission.”
    Wolfe, 40 Va. App. at 580, 
    580 S.E.2d at 474
    ; Kidder v. Va. Birth-Related Neuro. Injury Comp.
    Pgm., 
    37 Va. App. 764
    , 778, 
    560 S.E.2d 907
    , 913 (2002); Va. Birth-Related Neuro. Injury
    Comp. Pgm. v. Young, 
    34 Va. App. 306
    , 318, 
    541 S.E.2d 298
    , 304 (2001). This appellate
    deference is not a mere legal custom, subject to a flexible application, but a statutory command
    making clear that the commission’s decision “shall be conclusive and binding as to all questions
    of fact.” Code § 38.2-5011(A). Medical evidence, therefore, remains “subject to the
    commission’s consideration and weighing.” Wolfe, 
    40 Va. App. at 580
    , 
    580 S.E.2d at 474
    (quoting Young, 
    34 Va. App. at 318
    , 
    541 S.E.2d at 304
    ) (citations and internal quotation marks
    - 12 -
    omitted). And the appearance of “contrary evidence in the record is of no consequence if there is
    credible evidence to support the commission’s finding.” Id.; see also Kidder, 
    37 Va. App. at 778
    , 
    560 S.E.2d at 913
    .
    Despite this deference, appellants argue, the commission’s findings cannot be sustained
    because Dejuan’s death, by itself, overcomes any evidentiary weaknesses in their case. Under
    this theory, “the death of an infant from a birth-related oxygen deprivation injury automatically
    qualifies the infant under the Act.” We find this view flawed for two reasons.
    First, it is a non sequitur to assert that a disability — as that term is specifically defined
    and qualified in the statute — always precedes death or is subsumed by it. While an injury may
    be an anatomical antecedent to death, the same cannot be said of a statutory disability. It may or
    may not, depending on the facts. A per se rule equating death with disability mixes unrelated
    concepts because, as the commission correctly put it, “Death is the cessation of life, not a
    measure of disability.”
    Second, the Act is a comprehensive legislative enactment. It includes multiple provisions
    defining its terms, describing its scope, and qualifying its reach. Despite this elaborate statutory
    scheme, not a word expressly says (or, for that matter, reasonably implies) that death should
    automatically be equated with the highly specific definitional criteria used to determine the Act’s
    coverage. The omission of any statutory language treating death as a per se event covered by the
    Act, even if problematic as a policy matter, cannot be remedied by the courts.8 “The act of choosing
    carefully some words necessarily implies others are omitted with equal care.” Kane, 41 Va. App. at
    372, 585 S.E.2d at 353. “Any such change to the statute must be a legislative, rather than a judicial,
    undertaking.” Mouberry, 
    39 Va. App. at 584-85
    , 
    575 S.E.2d at 571
    . To advocate a statutory
    - 13 -
    8
    The 2003 session of the General Assembly added a new section to the statute addressing
    infant deaths within 180 days of birth. See Code § 38.2-5009.1 (2003 Va. Acts, ch. 897).
    Because the new provision applies prospectively only, we do not consider it.
    - 14 -
    interpretation that, if accepted, would essentially rewrite the legislative text “presupposes a power in
    the judiciary that simply does not exist.” Id. We thus reject appellants’ invitation to judicially graft
    into the statute an unwritten provision applying the Act to all newborns who die shortly after birth.9
    III.
    Because the commission applied correctly the legal principles governing the presumption
    and rested its factfinding on credible evidence, we affirm.
    Affirmed.
    9
    The Commission also recognized this limitation on its powers. Its opinion in this case
    concludes: “There is no presumption of disability in those cases where the infant dies shortly
    after birth. Even though there may be a valid argument for the creation of such a presumption,
    the Commission should not judicially change the clear language of the statute.”
    - 15 -