Department File Number : | M201781920 |
Claim Number : | 76760 |
Date Submitted : | 4/25/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ASCENSION HEALTH ALLIANCE PL/GL SELF-INSURED TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-7046706 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Linda | S | Zinselmeier | ||
Street Address | |||||
11775 Borman Drive | |||||
City | State | Zip | |||
Saint Louis | MO | 63146 | |||
Phone | Ext | Fax | E-Mail Address | ||
(314) 733 - 8727 | (314) 733 - 8727 | lzinselmeier@ascension.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | M | Dmytrenko | ||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 5153 N. 9th Ave., Suite 300 | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 32504 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1111 | $10,000,000 | $10,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62184 | Neurology - including child - no surgery - All Other |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
SACRED HEART HOSPITAL (PENSACOLA) | 100025 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Outpatient clinic | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/7/2011 | 6/14/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient with seizure, initially diagnosed with and treated for epilepsy. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Difficult resection of meningioma. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Patient ultimately diagnosed with a sphenoid wing meningioma. | |||||
Principal Injury Giving Rise To The Claim | |||||
Stroke with left-sided paralysis. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/7/2013 | 2012 CA 002744 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Escambia | 7/15/2015 | ||||
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 | |||||
6/23/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $2,198,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $92,964 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,808 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201781921 |
Claim Number : | 105143 |
Date Submitted : | 4/25/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ASCENSION HEALTH ALLIANCE PL/GL SELF-INSURED TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-7046706 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Linda | S | Zinselmeier | ||
Street Address | |||||
11775 Borman Drive | |||||
City | State | Zip | |||
Saint Louis | MO | 63146 | |||
Phone | Ext | Fax | E-Mail Address | ||
(314) 733 - 8727 | (314) 733 - 8727 | lzinselmeier@ascension.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | M | Dmytrenko | ||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 5153 N. 9th Ave., Suite 300 | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 32504 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1111 | $10,000,000 | $10,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62184 | Neurology - including child - no surgery - All Other |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
SACRED HEART HOSPITAL (PENSACOLA) | 100025 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Outpatient clinic | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/27/2013 | 5/4/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient with intermittent numbness, tingling and pain in lower extremities and then intermittent right-sided facial spasms; failure to diagnose multiple sclerosis, | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Lumbar spine MRI and head CT. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Patient alleged failure to diagnose and treat multiple sclerosis from the brain MRI and CT and, therefore, a failure to prescribe meds to treat the symptoms of the disease. | |||||
Principal Injury Giving Rise To The Claim | |||||
At the time the diagnosis was made by a different neurologist in 12/2015, the patient had little to no change in physical condition and little to no change in appearance of her updated brain MRI | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 9/14/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
9/14/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $400,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $400,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
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 : | M201575178 |
Claim Number : | FP4293801 |
Date Submitted : | 7/13/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12754 Gran Bay Parkway W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | M | Dmytrenko | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5153 North Ninth Avenue, Suite 300 | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 32504 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-98741 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62184 | Neurology - including child - no surgery - All Other |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SACRED HEART HOSPITAL (PENSACOLA) | 100025 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/24/2008 | 4/4/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient with seizures initially diagnosed with and treated for epilepsy. She was ultimately diagnosed with a sphenoid wing meningioma. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Due to tumor growth and edema, resection of the meningioma was more difficult and the patient suffered a stroke intraoperatively. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to timely diagnose meningioma. | |||||
Principal Injury Giving Rise To The Claim | |||||
Stroke with associated left sided paralysis. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/13/2012 | 2012 CA 002744 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Escambia | 6/19/2015 | ||||
Other Defendants Involved in this Claim | |||||
The Neurosurgical Group Sacred Heart Health System Sacred Hearth Medical Group Institute for Neurology and Neur | |||||
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 | |||||
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 | $19,146 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $7,513 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Dmytrenko |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. GEORGE M DMYTRENKO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GEORGE M DMYTRENKO, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).