Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M202091704 |
Claim Number : | 072882 |
Date Submitted : | 3/3/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
TDC SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-4241120 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lisa | Warner | |||
Street Address | |||||
29 Mill Street | |||||
City | State | Zip | |||
Unionville | CT | 06085 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 269 - 2824 | lisa.warner@tdcspecialty.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Augustine | Bollo | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 17779 SW 2nd Street | ||||
City | State | Zip Code | County | ||
Pembroke Pines | FL | 33029 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
P96147-14 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Podiatric Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PO2570 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
WESTON OUTPATIENT SURGICAL CENTER | 14960396 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/8/2011 | 2/5/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Posttraumatic synovitis with adhesive capsulitis, right ankle; Equinus contracture, right ankle | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Extensive ankle arthroscopy with debridement, right ankle; manipulation under anesthesia, right ankle joint | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to ensure proper safety measures in the operating room to prevent injury; and misplacement of tourniquet prior to & during surgical procedure performed on 4/8/11 caused or substantially contributed to emotional distress, pain, muscle spasms & injury to common peroneal nerve which is permanent in nature. | |||||
Principal Injury Giving Rise To The Claim | |||||
Ankle injury | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/20/2014 | 2014 011803 (12) | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 1/11/2018 | ||||
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 | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
2/5/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $135,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $133,082 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,485 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unable to determine due to Dr. Bollo's prolonged unavailability. |
Updates | |
No updates found. |
Department File Number : | M201676880 |
Claim Number : | 26510-1 |
Date Submitted : | 1/21/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LANCET INDEMNITY RISK RETENTION GROUP INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
26-1479165 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christopher | Teter | |||
Street Address | |||||
2810 West St. Isabel Street Suite 100 | |||||
City | State | Zip | |||
Tampa | FL | 33602 | |||
Phone | Ext | Fax | E-Mail Address | ||
(813) 290 - 8282 | 265 | cteter@lancetindemnity.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | AUGUSTINE | BOLLO | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 17779 SW 2nd Street | ||||
City | State | Zip Code | County | ||
Pembroke Pines | FL | 33029 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
LI091210001769 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Podiatric Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PO2570 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
WESTON OUTPATIENT SURGICAL CENTER | 14960396 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/3/2010 | 1/23/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Treatment was sought for a left ankle injury post fall. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
A left ankle arthroscopy was performed. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged damage to the saphenous nerve that resulted in pain and suffering. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/15/2013 | CACE-13-010532 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 12/8/2015 | ||||
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 | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/8/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $87,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $50,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurer is unaware of what steps have been taken. |
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.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Does Dr. AUGUSTINE A BOLLO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AUGUSTINE A BOLLO, MD has at least 4 medical malpractice case(s), lawsuit(s), or complaint(s).