Department File Number : | M201884433 |
Claim Number : | 2017FL248 |
Date Submitted : | 2/28/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS CASUALTY RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-3867083 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jody | Schwahn | |||
Street Address | |||||
611 Druid Road E, Suite 512 | |||||
City | State | Zip | |||
Belleair | FL | 33756 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 581 - 6400 | 1014 | jschwahn@physicianscasualty.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Atef | Zakhary | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 706 W. Platt Street | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33606 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PCX-2016-893 | $100,000 | $300,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME77931 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
TAMPA GENERAL HOSPITAL | 100128 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/20/2014 | 7/20/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Hysterectomy | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Hysterectomy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Bowel and vascular injury intra-operatively. | |||||
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 | ||||
11/22/2017 | 16-CA-010763 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 2/23/2018 | ||||
Other Defendants Involved in this Claim | |||||
Omni Medical Center for Women, PLC | |||||
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 | |||||
2/6/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $8,265 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $337 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201576633 |
Claim Number : | 70296 |
Date Submitted : | 6/27/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Trisha | D | Bowles | ||
Street Address | |||||
245 Riverside Avenue | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4068 | (888) 974 - 6458 | claims@mymedmal.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Atef | S | Zakhary | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 706 W Platt St | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33608 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707396 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME77931 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
TAMPA GENERAL HOSPITAL | 100128 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/10/2013 | 2/14/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was experiencing inflammation and significant menstrual bleeding | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Laparoscopic robot assisted hysterectomy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient's ureter was cut during robotic surgery | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/2/2015 | 14-CA-12613 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 12/5/2015 | ||||
Other Defendants Involved in this Claim | |||||
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 | ||||
Other | Dismissed due to settlement by parties | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
10/5/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $25,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $23,106 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $40,000 | ||||||||||||||||||||
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 conferenced with practitioner |
Updates | |||||||
Date of Change: | 6/27/2016 11:16:24 AM | ||||||
Reason for Change: | The amount of indemnity against the physician was submitted in error. | ||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ATEF ZAKHARY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ATEF ZAKHARY, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).