Dr. JOHN T SULLEBARGER, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. JOHN T SULLEBARGER, MD

509 S. Armenia Avenue, Suite 200

Indemnity Paid: $1,800,000.00

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	JOHN		T	SULLEBARGER
Insurer Type		Street Address of Practice
Licensed		509 S. Armenia Avenue, Suite 200
City		State	Zip Code	County
Tampa		FL	33609	Hillsborough
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600031 07		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME62629		Cardiovascular Disease - Minor Surgery		2307

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
Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
2/21/2006		1/10/2007

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.

Legal Information

Date of Suit			Circuit Court Case Number
4/4/2007			07-003982
County Suit Filed in			Date of Final Disposition
Hillsborough			1/17/2008
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 Decision			Other
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

Injured Person's Total Economic Loss

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 Changed	Former Value	New Value
Date of Final Disposition	10-DEC-07	17-JAN-08

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Does Dr. JOHN T SULLEBARGER, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. JOHN T SULLEBARGER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).