Medical Malpractice Cases

Dr. ARDESHIR KHADEMI-KERMANSHAHI Medical Malpractice Cases

Court Case # 2004-CA-3918

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640762
Claim Number :19653
Date Submitted :9/11/2006
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualArdeshir Khademi-Kermanshahi
Insurer TypeStreet Address of Practice
Licensed3930 8th Avenue West
CityStateZip CodeCounty
BradentonFL34205Manatee
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600154 03$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME80114Surgery - Neurology - Including Child51701

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MManatee
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MANATEE MEMORIAL HOSPITAL100035
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
12/23/20013/15/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Epidural abscess
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :344.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose epidural abscess
Principal Injury Giving Rise To The Claim
Irreversible spinal cord damage
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/16/20042004-CA-3918
County Suit Filed inDate of Final Disposition
Manatee9/1/2006
Other Defendants Involved in this Claim
Manatee Memorial Hospital
Bhamber, MD, Davinder
Singh, MD, Satnam
Shiels, DO, Martha
Gonzalez, MD, Ralph
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/2/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$36,870
All Other Loss Adjustment Expense Paid$26,999
Injured Person's Total Non-Economic Loss$500,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$300,000$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:9/11/2006 3:40:53 PM
Reason for Change:Report updated to reflect Court document final disposition date of 09/01/06, Dismissal
 
Field ChangedFormer ValueNew Value
Date of Final Disposition02-MAY-0601-SEP-06

 

 

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Court Case # 2015-CA-000071

Indemnity Paid: $250,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201575590
Claim Number : 52079
Date Submitted : 12/1/2015
 
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 ARDESHIR   KHADEMI-KERMANSHAHI
Insurer Type Street Address of Practice
Licensed PO Box 5048
City State Zip Code County
Clearwater FL 33758 Pinellas
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1601361 11 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME80114 Neurology - Including Child - Minor Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Pinellas
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
MEASE HOSPITAL - DUNEDIN 100043
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
11/6/2013 1/26/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Cervical spinal cord compression
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis of cervical spinal cord compression
Principal Injury Giving Rise To The Claim
Right leg uniplegia/right arm weakness
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
5/4/2015 2015-CA-000071
County Suit Filed in Date of Final Disposition
Pinellas 9/29/2015
Other Defendants Involved in this Claim
Mease Dunedin Hospital
Mischan, MD, Byron C
Radiology Associates of Clearwater
Kanaan, MD, Elias
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
8/11/2015
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $250,000
Loss Adjust Expense Paid to Defense Counsel $6,698
All Other Loss Adjustment Expense Paid $9,621
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $65,613 $0
Wage Loss $0 $1,000,000
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change: 12/1/2015 3:03:47 PM
Reason for Change: Report updated to reflect Court Document final disposition date of 9/29/15
 
Field Changed Former Value New Value
Date of Final Disposition 11-AUG-15 29-SEP-15

 

 

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Court Case # 15-005872-CI

Indemnity Paid: $0.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201886804
Claim Number : 53335
Date Submitted : 10/22/2018
 
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   (404) 842 - 3319 ctschanz@magmutual.com
 
Insured Information
 
Type First Name MI Last Name
Individual ARDESHIR   KHADEMI-KERMANSHAHI
Insurer Type Street Address of Practice
Licensed 1840 Mease Dr. Ste. 4078
City State Zip Code County
Safety Harbor FL 34695 Pinellas
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1601361 11 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME80114 Neurology - Including Child - Minor Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Pinellas
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
11/9/2012 5/20/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Intra-orbital fungal infection
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis and treatment of intra-orbital fungal infection
Principal Injury Giving Rise To The Claim
Left eye enucleation
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
9/18/2015 15-005872-CI
County Suit Filed in Date of Final Disposition
Pinellas 9/10/2018
Other Defendants Involved in this Claim
Dupree, MD, Dana M
The Macular Center
Handza, DO, Jason M
Gulf Coast Retina Center
Countryside Neurology
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 $33,622
All Other Loss Adjustment Expense Paid $12,733
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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