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
Insurer FEINProfessional License Number
Insurer Contact Information
TypeFirst NameMILast Name
IndividualBarbara EKuberry
Street Address
1888 Century Park East
Century CityCA90067
PhoneExtFaxE-Mail Address
(310) 556 - 7418 (310) 556 -
Insured Information
TypeFirst NameMILast Name
Insurer TypeStreet Address of Practice
LicensedPO BOX 869
CityStateZip CodeCounty
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number

Medical Malpractice Closed Claims Report

Injured Person Information
First NameMILast NameDate of Birth
Street AddressGenderCounty where Injury Occurred
CityStateZip Code
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
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
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
County Suit Filed inDate of Final Disposition
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. 
Claim not subject to Arbitration.
Date of Payment
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
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
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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