Department File Number : | M201680113 |
Claim Number : | HOS-MM-150131 |
Date Submitted : | 10/21/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CATLIN SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
71-6053839 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | Catlin Specialty Insurance Co. | ||||
Street Address | |||||
3340 Peachtree Road, NE | |||||
City | State | Zip | |||
Atlanta | GA | 30326 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 439 - 6133 | paul.moore@xlcatlin.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jacob | Gerzenshtein | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 4410 W. Boy Scout Blvd., Suite 175 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33607 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
ADM-684266-0316 | $3,000,000 | $10,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME95719 | Surgery - Plastic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | 4410 W. Boy Scout Blvd., Tampa, FL 33607 | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/8/2015 | 9/8/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Elective surgery for body sculpting | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Liposuction and Brazilian Butt Lift | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Dr. Gerzenshtein was not alleged to have made a misdiagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
Delayed diagnosis of buttock infection leading to critically low blood pressure, leading to excessive use of pressures, leading to limb death and loss. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/6/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
5/6/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $3,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $34,208 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $2,000,000 | ||||||||||||||||||||
Deductible | $10,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of sanitary practices |
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 : | M201987806 |
Claim Number : | HOS-MM-150131 |
Date Submitted : | 2/11/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CATLIN SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
71-6053839 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | LaSorte | |||
Street Address | |||||
3340 Peachtree Road, NE, Tower Place 100, Suite 2950 | |||||
City | State | Zip | |||
Atlanta | GA | 30326 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 443 - 5262 | denise.lasorte@axaxl.com |
Insured Information | |||||
Type | Entity Name | ||||
Entity | Body Sculpt International LLC | ||||
Insurer Type | Street Address of Practice | ||||
Licensed | Sono Bello Body Contour Center, 4410 W. Boyscout Blvd., Ste. 175 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33607 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
ADM-684266-0316 | $3,000,000 | $10,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Cosmetic Medicine | ||||
License Number | Specialty Code & Classification | Certification Number | |||
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Contour Center | ||||
Name of Institution | Code | ||||
AESTHETIC PLASTIC SURGERY CENTER | 114 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Operating Suite | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/7/2015 | 9/8/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Urosepsis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Brazilian buttock lift | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Improper technique | |||||
Principal Injury Giving Rise To The Claim | |||||
Surgical site infection | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/6/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
4/26/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $3,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $37,962 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $3,000,000 | ||||||||||||||||||||
Deductible | $10,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Do not know. |
Updates | |
No updates found. |
Does Dr. JACOB GERZENSHTEIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JACOB GERZENSHTEIN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).