Medical Malpractice Cases

Dr. CATHY M BALBIN Medical Malpractice Cases

Court Case # 03-4296CI-15

Indemnity Paid: $32,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537331
Claim Number :500984
Date Submitted :10/13/2005
 
Insurer Information
 
Insurer NameCoverage Type
AMERICAN HEALTHCARE INDEMNITY COMPANYPrimary
Insurer FEINProfessional License Number
59-2048400 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualBarbara EKuberry
Street Address
1888 Century Park East
CityStateZip
Century CityCA90067
PhoneExtFaxE-Mail Address
(310) 556 - 7418 (310) 556 - 7400bkuberry@scpie.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualCATHYMBALBIN
Insurer TypeStreet Address of Practice
LicensedPO BOX 869
CityStateZip CodeCounty
LARGOFL33779-0869Pinellas
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0022000130$500,000$1,500,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS5572Anesthesiology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPinellas
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SUN COAST HOSPITAL100015
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
2/1/20012/5/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
swallowed tooth following anesthesia for ECT procedure
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
general anesthesia
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
swallowed tooth
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/30/200303-4296CI-15
County Suit Filed inDate of Final Disposition
Pinellas9/9/2004
Other Defendants Involved in this Claim
Largo Anesthesia Assoc
Warren , GeorgeL
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
9/8/2004
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$32,500
Loss Adjust Expense Paid to Defense Counsel$11,896
All Other Loss Adjustment Expense Paid$8,304
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
investigation, expert reports, discovery, compromise settlement
 
Updates
 
 
Date of Change:10/13/2005 2:47:19 PM
Reason for Change:forgot to enter amount paid
 
Field ChangedFormer ValueNew Value
Indemnity Paid03250000
Settlement Reached01
 
Date of Change:10/13/2005 2:50:11 PM
Reason for Change:enter wrong payment amount
 
Field ChangedFormer ValueNew Value
Indemnity Paid325000032500

 

 

*NR:Prior to 04/28/1999 this field was not required in submitted claims.

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