Dr. JOELLE M INNOCENT-SIMON, MD Medical Malpractice Cases, Lawsuits, and Complaints

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Phycicians Practice Address

Dr. JOELLE M INNOCENT-SIMON, MD

1210 Andrews Circle

Starke, FL

32091

Bradford

Court Case # 07-CA-257

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M200747474
Claim Number :	25190
Date Submitted :	1/28/2008

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	cwehner@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	Joelle		M	Innocent-Simon
Insurer Type		Street Address of Practice
Licensed		1210 Andrews Circle
City		State	Zip Code	County
Starke		FL	32091	Bradford
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600460 05		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Osteopathic Physician
License Number		Specialty Code & Classification		Certification Number
OS6902		Family Physicians or General Practitioners - No Surgery		1175

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Bradford
City			State	Zip Code

Location where injury occured		Other location where injury occured
Nursing Home
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
1/15/2006		2/26/2007

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Thromboembolic event of bilateral lower extremities
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :		747.64
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely and appropriately conduct tests, order consults, and transfer patient to the hospital
Principal Injury Giving Rise To The Claim
Death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
6/1/2007			07-CA-257
County Suit Filed in			Date of Final Disposition
Bradford			11/28/2007
Other Defendants Involved in this Claim
E&M Medical 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
10/24/2007

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

$10,024

All Other Loss Adjustment Expense Paid

$2,790

Injured Person's Total Non-Economic Loss

$250,000

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$79,339	$0
Wage Loss	$0	$0
Other Expenses	$5,700	$0

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Risk management has counseled insured

Updates

Date of Change:

1/28/2008 3:31:38 PM

Reason for Change:

Report updated to reflect Court Document final disposition date of 11/28/07

Field Changed	Former Value	New Value
Date of Final Disposition	12-OCT-07	28-NOV-07

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Court Case # 04-2003-CH-0461

Indemnity Paid: $125,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M200953125
Claim Number :	18387
Date Submitted :	5/13/2009

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	cwehner@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	Joelle		M	Innocent-Simon
Insurer Type		Street Address of Practice
Licensed		1550 S. Water St.
City		State	Zip Code	County
Starke		FL	32091	Bradford
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600460 01		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Osteopathic Physician
License Number		Specialty Code & Classification		Certification Number
OS6902		Family Physicians or General Practitioners - No Surgery

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Bradford
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
SHANDS HOSPITAL		100113
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
6/26/2002		9/8/2003

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Myocardial Infarction
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Catheterization
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose MI
Principal Injury Giving Rise To The Claim
Myocardial infarction
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
8/13/2003			04-2003-CH-0461
County Suit Filed in			Date of Final Disposition
Bradford			5/4/2009
Other Defendants Involved in this Claim
Shands Teaching Hospital Gros, MD, Bernard
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
3/30/2009

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$125,000

Loss Adjust Expense Paid to Defense Counsel

$174,316

All Other Loss Adjustment Expense Paid

$68,355

Injured Person's Total Non-Economic Loss

$125,000

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$41,000	$0
Wage Loss	$100,000	$0
Other Expenses	$0	$0

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Risk management has counseled insured

Updates

Date of Change:

5/13/2009 3:48:46 PM

Reason for Change:

Report updated to reflect Court Document final disposition date of 05/04/09

Field Changed	Former Value	New Value
Date of Final Disposition	26-MAR-09	04-MAY-09

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Frequently Asked Questions

Does Dr. JOELLE M INNOCENT-SIMON, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. JOELLE M INNOCENT-SIMON, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).