Department File Number : | M201472465 |
Claim Number : | 44680 |
Date Submitted : | 11/17/2014 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Allan | J | Birnbaum | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1701 SE Hillmoor Dr. Ste. 5 | ||||
City | State | Zip Code | County | ||
St. Lucie | FL | 34952 | St. Lucie | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1600034 14 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS4258 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | St. Lucie | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/7/2011 | 4/30/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Oral thrush | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Prescribed Diflucan | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to appreciate potential dangerous interaction of Tacrolimus and Diflucan | |||||
Principal Injury Giving Rise To The Claim | |||||
Tacrolimus toxicity and renal failure | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/23/2013 | 562013CA002667 | ||||
County Suit Filed in | Date of Final Disposition | ||||
St. Lucie | 11/4/2014 | ||||
Other Defendants Involved in this Claim | |||||
Casey, PA, Kevin Allan Jay Birnbaum, DO, PA | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
10/1/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $112,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $36,817 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $10,855 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |||||||
Date of Change: | 11/17/2014 1:58:50 PM | ||||||
Reason for Change: | Report updated to reflect Court Document final disposition date of 11/4/14 | ||||||
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Department File Number : | M201574641 |
Claim Number : | 47164 |
Date Submitted : | 8/4/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Allan | J | Birnbaum | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1701 SE Hilmoor Dr., Ste. 5 | ||||
City | State | Zip Code | County | ||
Port Saint Lucie | FL | 34952 | St. Lucie | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1600034 14 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS4258 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | St. Lucie | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/19/2012 | 1/7/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Aortic valve replacement | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No iatrogenic injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to monitor and treat patient's INR level | |||||
Principal Injury Giving Rise To The Claim | |||||
GI bleed | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/9/2014 | 14-9001-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 7/8/2015 | ||||
Other Defendants Involved in this Claim | |||||
Casey, PAC, Kevin University of Miami Rubinfeld, MD, Allan R Dade Intensive Care Hospitalists | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $42,914 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $12,490 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |||||||
Date of Change: | 8/4/2015 4:03:34 PM | ||||||
Reason for Change: | Report updated to reflect Court Document final disposition date of 07/08/15 | ||||||
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Does Dr. ALLAN J BIRNBAUM, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ALLAN J BIRNBAUM, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).