Medical Malpractice Cases

Dr. Don D Weiffenbach Medical Malpractice Cases

Court Case # CA-00-1889

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

Department File Number :M200432394
Claim Number :11494
Date Submitted :11/9/2005
Insurer Information
Insurer NameCoverage Type
Insurer FEINProfessional License Number
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 -
Insured Information
TypeFirst NameMILast Name
Insurer TypeStreet Address of Practice
Licensed430 Oak Cove Road
CityStateZip CodeCounty
TitusvilleFL32780St. Johns
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 0105131 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME10846Emergency Medicine - No Major Surgery 

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
Emergency Room 
Name of InstitutionCode
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pulmonary embolus
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Emergency medicine evaluation
Diagnostic Code :415.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely diagnose PE
Principal Injury Giving Rise To The Claim
Pulmonary embolus
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report


Legal Information
Date of SuitCircuit Court Case Number
County Suit Filed inDate of Final Disposition
St. Johns7/16/2004
Other Defendants Involved in this Claim
Grobelny, MD, Mark
Emergency Physicians, Inc.
Flagler Hospital
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$250,000
Loss Adjust Expense Paid to Defense Counsel$4,187
All Other Loss Adjustment Expense Paid$3,607
Injured Person's Total Non-Economic Loss$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$10,534$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.
Date of Change:11/9/2005 9:16:34 AM
Reason for Change:Corrected various fields pursuant to State audit
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid03607
Amount of Loss Adjustment Expense Paid to Defense Counsel623104187
Insured License NumberFL 010846ME10846
Date of Final Disposition05-AUG-0416-JUL-04
Defendant Entity NameFlagler Hospital
Payment Date05-AUG-0404-AUG-04
Defendant Last NameGrobelny, MD, Mark
Defendant Entity NameEmergency Physicians, Inc.
No Other Defendants10



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