Department File Number : | M201679454 |
Claim Number : | 54230/54231 |
Date Submitted : | 11/9/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | P | Shaughness | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4516 Armania Avenue | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33603 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1602053 11 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME50101 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT JOSEPH'S HOSPITAL | 100075 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/13/2014 | 8/10/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Empyema, herniation, neurologic injury | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
CT of brain | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to properly interpret CT of brain | |||||
Principal Injury Giving Rise To The Claim | |||||
Empyema, herniation, neurologic injury | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/14/2016 | 16-CA-000330 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 10/13/2016 | ||||
Other Defendants Involved in this Claim | |||||
Paltoo, MD, Karen St. Joseph's Hospital SDI Diagnostic Imaging USF Health | |||||
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 | |||||
8/2/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $1,975,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $15,905 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $19,994 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |||||||
Date of Change: | 11/9/2016 2:42:46 PM | ||||||
Reason for Change: | Report updated to reflect Court Document final disposition date of 10/13/16 | ||||||
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Department File Number : | M201677141 |
Claim Number : | 48274/48275 |
Date Submitted : | 2/15/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | P | Shaughness | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4645 NW 8th Ave. | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33603 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1602053 09 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME50101 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
PALM BEACH GARDENS MEDICAL CENTER | 100176 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/24/2012 | 4/14/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Stroke | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
CT of brain | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to properly interpret CT | |||||
Principal Injury Giving Rise To The Claim | |||||
Embolic/ischemic infarction, hemorrhagic stroke | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/31/2014 | 2014CA009304AF | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 1/26/2016 | ||||
Other Defendants Involved in this Claim | |||||
Villa, MD, Augusto E Palm Beach Cardiovascular Clinic SDI & Assoc. Gardens Radiology Assoc. Le, MD, Da Huu Palm Beach Gardens Medical Center Inphynet Contracting Services | |||||
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 | |||||
1/26/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $500,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $75,866 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $52,374 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |
No updates found. |
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Does Dr. GEORGE P SHAUGHNESS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GEORGE P SHAUGHNESS, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).