< PreviousAttorney at Law Magazine First Coast sat down with Bob Ledoux the new president of North Flori- da Chapter of the Association of Corporate Coun- sel (NFLACC) to discuss his plans for the organi- zation under his leadership. Ledoux is senior vice president and general counsel for the Florida East Coast Railway. ASSOCIATION PROFILE BOB LEDOUX WITH ACC NORTH FLORIDA EXECUTIVE DIRECTOR KATHARINE B. HARTLAND “We are here to help provide education, networking, and public benefit to the in-house legal community.” ATTORNEY AT LAW MAGAZINE · FIRST COAST · VOL. 4 NO. 5 20AALM: As the new president, what are your goals for the association in the coming year? Ledoux: I have three goals this year, grow our membership, provide great social and CLE experiences for our members and expand our giving back to the community. AALM: What lessons have you learned from your predecessors? Ledoux: The leadership in the past has been great, Mike Herman was a great motiva- tor; Harvey Granger showed great compassion; and Mo- nique Brown expanded our outreach program providing a great mentor experience for high school students. AALM: Tell us about some up- coming events the association has planned for members. Ledoux: We have several events for the rest of the year. The highlights are our well at- tended CLE on ethics this fall and our employment seminar combined with a Christmas party. AALM: Tell us about any cur- rent or planned partnerships with other local associations. How will these partnerships benefit members? Ledoux: The NFLACC is a member of both the JAX Chamber and the World Af- fairs Council. As a member our members get to participate in great events hosted by these two or- ganizations. AALM: What benefits are there to at- torneys who become actively involved in the association? Ledoux: There are several benefits for getting actively involved in the NFLACC, CLE credits, great social events, great networking and the op- portunity to meet with legal industry leaders. AALM: What advice do you have for a member looking to increase their involvement in the association? For a member hoping to join the leader- ship? Ledoux: You reach out to any of the current board members. We are cur- rently looking for new board and committee members. AALM: What changes in the legal community does the leadership an- ticipate will affect the association and its members? Ledoux: The diverse areas of the law make it a challenge to ensure we pro- vide great CLE programming that is relevant for the most members. We have focused on large industry areas of law such has health care, banking, real estate and transportation. By focusing on these large areas and no specific laws, we are able to attract more members to events. AALM: How would you describe the main goal of the association in your own words? Ledoux: We are here to help provide education, networking, and public benefit to the in-house legal commu- nity. For more information about the North Florida Chapter of the Association of Corporate Council: www. https://www.acc.com/chapters- networks/chapters/north-florida Bob Ledoux of ACC North Florida Chapter AttorneyAtLawMagazine.com 21Y ou might have a client seeking advice from you on their home renovation project, or you may be wanting to remodel your own home. More times than not, when a client calls you with contractor prob- lems, the project is already spiral- ing down and a dispute is imminent. This article will provide you and/or your clients with some preliminary tips and advice on remodeling their homes. 1. Contractor Selection – Contrac- tor selection is key. Most renovation projects are extensive and require the property to be occupied during the project. Once you identify a contrac- tor, make sure you are hiring a prop- erly licensed contractor. Certified General Contractor (CGC), Certified Building Contractor (CBC) and Cer- tified Residential Contractor (CRC) are the three license types qualified to renovate any residential property. Once you verify the license type, ask for and seek references from the con- tractor’s prior clients. Google searches can be useful for prior customer sat- isfaction. Conduct an interview with the contractor and ask them to see work on prior projects. Do they have any ongoing project that you can visit? Ask. You will also want to know what subcontractors will be used for the renovation project. The subcontrac- tors do most of the actual work and you will want to review their qualifi- cations and references if possible. 2. Contract Review and Pricing – Review your client’s proposed renova- tion contract carefully. There are many factors to consider when reviewing a construction agreement. Particular attention should be paid to the pric- ing structure set out in the contract (i.e. lump sum, cost plus, etc.). You should consider having a guaranteed maximum price or “GMP” to hold the contractor accountable for cost over- runs. Do not ever agree to anything more than 10% deposit and make sure your client is holding retainage of at least 10% on each payment. Contrac- tors many times look to front load their payment applications early in the project so make sure you base the payment schedule on clearly identifi- able project milestones like “comple- tion of the slab”, “dry in” or “passing final inspection”. Schedule release of the retainage to the contractor on oc- cupancy of the property. Additionally, make sure the contractor selected for the project is properly insured. Many lenders will require a Builders Risk insurance policy for the duration of the project. Discuss the insurance coverages with your client to ensure they are adequately protected. 3. Contract Administration Dur- ing the Project – If your client has a lender handling the draw payments, then the lender will typically handle the gathering of lien releases from all the trades. Review the construc- tion loan documents to ensure they comply with all inspections and fund the draws properly. However, having a lender does not obviate the need to stay on top of lien releases. Your client will receive Notices to Owner during the project. It is merely a notice that the contractor has engaged a subcon- tractor to do work. Do not authorize any payment to the contractor with- out first receiving a release from the sub. Failure to obtain the release from the subcontractor can result in your client paying twice for the work. 4. Allowances and Change Orders – This is the single most disputed part of any construction renovation proj- ect. Many initial bids for residential projects have line items which are based on an allowance. For example, “Cabinet allowance is $20,000”. Make sure your client pays attention to the allowances. If they ultimately select cabinets that are double the allow- ance, they are responsible for funding the allowance cost overrun. Think of the allowance as a mere placeholder that will be reconciled at the comple- tion of the work. Busting the allow- ance can dramatically increase the project cost and provide owners with significant sticker-shock. Change or- ders are like-wise a source of dispute. Lump Sum pricing and/or a GMP can limit your exposure to excessive change orders. Be wary of the con- tractor with the lowest bid, because they can sometimes make up for the low bid with change orders. Have a clearly identified process addressing the presentation and acceptance of change orders. 5. Dispute Resolution – For resi- dential renovation projects, forget about arbitration. It is too expensive and uncertain. The filing fees are high and the parties need to pay fees asso- ciated with the arbitrator’s time. Fur- thermore, there is no (or very limited) appeal rights to a binding arbitration proceeding. Instead, disputes should be determined in the court system with a requirement to engage in pre- suit mediation. Do not waive your right to a jury trial either. Unscrupu- lous contractors do not look good in front of juries so make sure your cli- ent’s right to a jury trial remains in- tact. Do not agree to another venue other than were the project is located. And finally, make sure that your cli- ent has a contractual right to recover at- torney fees if they prevail in the dis- pute. CHRISTOPHER COBB | Construction Law Christopher Cobb is a co-founder of Cobb & Gonzalez and serves as the firm’s managing partner. Mr. Cobb prac- tices in the areas of construction law, community association law and business litigation. Mr. Cobb achieved expert status in construction law by The Florida Bar as a Board Certified Construction Attorney. In 2012, Mr. Cobb was appointed by The Honorable Rick Scott, Governor of the State of Florida, to the Construction Industry Licensing Board. In 2017, he was voted by his peers to serve as the youngest chairman in the history of the CILB and is also the first Division II consumer member to ascend to the chair position. Top 5 Things You Should Consider When Renovating Property AttorneyAtLawMagazine.com 23AALM: When did you first know you wanted to become an attorney? Haines: I’ve always had a strong in- terest in advocating for what I believe in and helping others achieve their goals. My mother first suggested I be- come a lawyer when I was in elemen- tary school. The passion remained with me through law school, where my favorite classes were contracts and business associations. I decided to pursue my MBA simultaneously and fell in love with business administra- tion and management. I really enjoy helping companies, both large and small, by providing legal counsel for every facet of their business. AALM: What drew you to your cur- rent firm? Haines: Smith Hulsey & Busey has long had an incredible reputa- tion, both in Jacksonville and beyond. The firm is a leader in the legal com- munity, which means I get to work alongside some of the great minds in our profession every day. I’m honored to grow my practice and learn from lawyers who have decades of experi- ence, hopefully contributing to the firm’s success and leaving a legacy of my own. Plus, I can combine my pas- sion for business law with the firm’s renowned healthcare practice — it’s a perfect fit. I’m fortunate to work with this amazing team. AALM: Where do you see your ca- reer going? Haines: I’ve truly found my home at Smith Hulsey & Busey. It’s the best of both worlds. The firm has both an established legacy and an immense opportunity for growth. I’m excited to be a part of the firm’s next generation and carry on the tradition of provid- ing our clients with reliable, efficient and effective counsel. I plan to have a long, tenured career here and hope to be a part of the firm’s leadership one day. AALM: As technology continues to evolve, how has it impacted your practice? Haines: We’ve seen a surge of on- line resources in recent years. Some small businesses, in an attempt to cut costs, have resorted to using internet resources instead of seeking legal ad- vice. However, every circumstance is RISING STAR Kayla A. Haines A Perfect Fit MY GOAL IS TO PUSH MYSELF PROFESSIONALLY AND BE KNOWN AS A LAWYER WHO GENUINELY PUTS MY CLIENTS’ NEEDS FIRST. ATTORNEY AT LAW MAGAZINE · FIRST COAST · VOL. 4 NO. 5 24STEPHEN D. BUSEY AND KAYLA A. HAINES SMITH HULSEY & BUSEY One Independent Drive, Suite 3300 Jacksonville, Florida 32202 (904) 359-7737 www.smithhulsey.com PRACTICE AREAS Mergers and Acquisitions Corporation, Securities, and Business Law Health Care Commercial Real Estate EDUCATION Juris Doctor, Florida Coastal School of Law MBA, Jacksonville University Bachelor of Arts, University of North Texas BAR ADMISSIONS The Florida Bar HONORS Jacksonville Bar Association, Young Lawyers’ Association Board Member Jacksonville Women Lawyers Association, Director of Judicial Reception Florida Coastal School of Law Alumni Association, Jacksonville Chapter President different and online forms are not a silver bullet. Just like shoes, forms are not one-size-fits-all, and many will not work across all scenarios. I encourage small business owners to seek legal advice when embarking on any decision that may have long-term legal repercussions. Trusting a generic online resource over an experienced professional isn’t worth the risk. AALM: Working with senior partners what is a trait they have that you would like to carry through to the next generation of lawyers? Tell us about a trait the newer generation of lawyers bring to the table. Haines: The senior partners I work with have an extraordinary work ethic and unparalleled dedication to the clients they serve. They go the extra mile for their clients, no matter the cost. The next gen- eration of lawyers should not be complacent and rely on relationships established by their predecessors. I hope to build on the foundation that our senior partners have laid. I also think more senior partners — and lawyers of any age, really — should be open-minded and not rely on “that’s what worked in the past.” Thinking creatively and pursuing fresh, diverse perspectives is crucial. AALM: What do you most hope to accomplish in the future? Haines: My goal is to push myself professionally and be known as a lawyer who genuinely puts my clients’ needs first. I want to learn from the lawyers and leaders I admire most while staying true to the passion for advocacy I’ve had since childhood. I hope to one day become an equity partner and board member at Smith Hulsey & Busey, and I plan to continue providing leadership in local voluntary bar organizations and The Florida Bar. At a GlanceS epsis is the overwhelming re- sponse of the body to infection that can lead to tissue damage, organ failure and death. The definition per the Surviving Sepsis Campaign (SSC) is a “life threatening organ dys- function caused by a dysregulated host response to infection.” Sepsis is diagnosed by a group of symptoms, with presence of suspected infection and is a medical emergency. It is a frightening fact that approximately 30 % of patient’s diagnosed with sepsis don’t survive. In review of medical cases involv- ing sepsis I have found despite a huge push to educate healthcare provid- ers about the signs and symptoms of sepsis and initiate sepsis protocols in hospitals; the diagnosis gets missed, or mistreated. Laura Evans, MD, MSc stated in “A Closer Look at Sepsis As- sociated Mortality” suboptimal care was found in 22.7% of sepsis associ- ated deaths, based on a survey of 3 academic medical centers and three affiliated hospitals. The numbers are estimated to be higher: 35.5-46% in survey of a larger sample of facili- ties. The Surviving Sepsis Campaign was initiated in 2004, and renewed in 2008, 2012, and 2016 outlining best practices for treatment of sepsis and continues to evolve. Compliance with treatment bundles has been shown to decrease sepsis related death by 36- 40% The 1-hour bundle includes: • Measurement of lactate levels, with re-assessment in 2-4 hours if the value was >2mmol/L. Increased lactate levels are associated with worse outcomes. • Obtaining blood cultures prior to administration of antibiotics. • Administering broad spectrum antibiotics, geared toward the sus- pected type of infection. Failure to initiate or delay in empiric antibi- otic treatment is associated with substantial increase in morbidity and mortality. • Fluid resuscitation 30 ml/kg of crystalloid fluids for hypotension or Lactate >=4.0mmol/L; complet- ed within 3 hours of recognition of sepsis. • Vasopressor medications for hy- potension which remains persis- tent despite fluid resuscitation to maintain a mean arterial pressure (MAP) of >=65 mmHg. SOFA or Sequential Organ Failure Assessment is used to define sep- sis and predict in hospital mortal- ity. qSOFA (quick SOFA criteria) was developed to assist in “quick” iden- tification and treatment outside the critical care area, and involve any two findings noted below, plus a potential source of infection: • Respiratory rate greater than or equal to 22/min. • Glasgow Coma Score < 15 (altered mentation). • Systolic BP less than 100 mmHg. The window of successful treatment is at the beginning of the “three stages of sepsis”, with mortality increasing significantly if treatment is delayed. “Sepsis Syndromes in Adults” by Remi Neviere, MD describes these stages as: STAGE 1: EARLY SEPSIS: INFECTION AND BACTEREMIA: Sepsis can be hard to identify in this stage. Use of SOFA criteria and monitoring of vital signs including temperature, and lab work particu- larly white blood cells and platelets are important to catching patients in early sepsis, and treating to prevent, or mitigate progression. STAGE 2: SEVERE SEPSIS— LIFE THREATENING ORGAN DYSFUNCTION: The damage has begun. Decreased blood pressure, causes decreased or- gan perfusion, leading to organ injury or failure. This cascade of events leads to decreased urine output, changed mentation, decreased platelet count, shortness of breath, decreased cardiac function, and abdominal pain. STAGE 3: SEPTIC SHOCK— VASODILATORY OR DISTRIBUTIVE SHOCK: Criteria for septic shock include hypotension (MAP >=65 mmHg) which remains despite fluid resus- citation and use of vasopressors to support blood pressure. This finding, along with elevation of lactate levels (>2mmol/L) after fluids resuscita- tion, caused by metabolic acidosis increases the possibility of death dra- matically. Earlier this year a study conducted at the University of Pittsburg identi- fied 4 clinical phenotypes of sepsis that may allow more precise therapy and improve care of critically ill pa- tients, as reported in JAMA. These classifications consist of: • Alpha phenotype: patients on the lowest dose of a vasopressor, with the lowest mortality (5 percent). • Beta phenotype: older patients with chronic illnesses and renal dysfunc- tion, with mortality of 13 percent. • Gamma phenotype: patients with inflammation and pulmonary dys- function, with mortality of 24 per- cent. • Delta phenotype: patients with liver dysfunction and septic shock, who had the highest mortality at 40 per- cent The key to sepsis treatment and survival is to identify and treat early in onset. Despite increased awareness healthcare providers continue to miss or mismanage sepsis patients. The key to review of potential cases involv- ing sepsis is knowledge of the current guidelines with re- view of the records to document expe- dient diagnosis and treatment that is cohesive with best practices. PATTY MITCHELL RN | Legal Health Care Patty Mitchell, RN, BSN, CLNC is the president of Central Florida Legal Nurse Consultants. Her nursing career has spanned over 24 years, in the hospital acute care setting. She is a graduate of the Medical Legal Consulting Insti- tute and maintains her certification. Patty is the president elect of the Greater Orlando Chapter of the American Association of Legal Nurse Consultants. She has provided consulting services since 2014, to both plaintiff and defense attorneys on a wide variety of cases. She is a member of the National Association of Certified Legal Nurse Consultants, and Sigma Theta Tau, nursing honor society. Sepsis: The Devil is in the Details AttorneyAtLawMagazine.com 27Locally –owned provider of virtual office solutions. 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