Medical Malpractice Cases

Dr. Jacob K Agamasu Medical Malpractice Cases

Court Case # 2016-CA-001317-09M-W

Indemnity Paid: $250,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201680518
Claim Number : 55903
Date Submitted : 1/20/2017
 
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 Jacob K Agamasu
Insurer Type Street Address of Practice
Licensed 1355 S. International Pkwy. Ste. 1491
City State Zip Code County
Lake Mary FL 32746 Seminole
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1602318 08 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME85101 Cardiovascular Disease - Minor Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Seminole
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
CENTRAL FLORIDA REGIONAL HOSPITAL (SANFORD) 100161
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
11/2/2014 12/15/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Renal calculus
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to appropriately manage anticoagulation therapy
Principal Injury Giving Rise To The Claim
Stroke
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
6/1/2016 2016-CA-001317-09M-W
County Suit Filed in Date of Final Disposition
Seminole 12/19/2016
Other Defendants Involved in this Claim
Eoonous, DO, Bibi S
Young, MD, Marvin J
Desamour, MD, Junia
Urology Wellness Ctr @ Lake Mary
Mid-Florida Hosp. Specialists
A-Plus Central FL Health Care
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
11/11/2016
 
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 $27,554
All Other Loss Adjustment Expense Paid $4,699
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $1,000,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change: 1/20/2017 1:35:38 PM
Reason for Change: Report updated to reflect Court Document final disposition date of 12/19/16
 
Field Changed Former Value New Value
Date of Final Disposition 11-NOV-16 19-DEC-16

 

 

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