Medical Malpractice Cases

Dr. JOHN T SULLEBARGER Medical Malpractice Cases

Court Case # 07-003982

Indemnity Paid: $1,800,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747986
Claim Number :24931/24932
Date Submitted :1/30/2008
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJOHNTSULLEBARGER
Insurer TypeStreet Address of Practice
Licensed509 S. Armenia Avenue, Suite 200
CityStateZip CodeCounty
TampaFL33609Hillsborough
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600031 07$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME62629Cardiovascular Disease - Minor Surgery2307

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MHillsborough
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
2/21/20061/10/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Cardiac arrhythmia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescribe beta pace on outpatient basis
Diagnostic Code :410.9
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to admit patient to hospital
Principal Injury Giving Rise To The Claim
Cardiac arrest
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/4/200707-003982
County Suit Filed inDate of Final Disposition
Hillsborough1/17/2008
Other Defendants Involved in this Claim
Florida Cardiovascular Institute
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/19/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,800,000
Loss Adjust Expense Paid to Defense Counsel$13,466
All Other Loss Adjustment Expense Paid$7,599
Injured Person's Total Non-Economic Loss$1,800,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$1,000,000
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:1/30/2008 12:46:05 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 01/17/08
 
Field ChangedFormer ValueNew Value
Date of Final Disposition10-DEC-0717-JAN-08

 

 

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