Medical Malpractice Cases

Dr. JORGE C ANTUNEZ-DE-MAYOLO V Medical Malpractice Cases

Court Case # 16-0200626CA06

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201886971
Claim Number : 340588
Date Submitted : 11/11/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual JORGE C ANTUNEZ-DE-MAYOLO V
Insurer Type Street Address of Practice
Licensed 3659 South Miami Avenue Suite 2001
City State Zip Code County
Coconut Grove FL 33133 Dade
Policy Number Per Claim Policy Limits Aggregate Policy Limits
884139 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME47826 Internal Medicine - No 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
  F Dade
City State Zip Code
     
Location where injury occured Other location where injury occured
Patient's Home  
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Patient's Home
Date of Occurrence Date Reported to Insurer
4/4/2013 3/22/2016
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented for treatment of Burkitt's Lymphoma.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient died of her aggressive Burkitt's Lymphoma.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was none.
Principal Injury Giving Rise To The Claim
Death.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
8/18/2016 16-0200626CA06
County Suit Filed in Date of Final Disposition
Dade 10/17/2018
Other Defendants Involved in this Claim
Oncology & Radiation Associates, PA
Hernandes, PA, Yessica
Morin, PA, Lisellet
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
10/17/2018
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $500,000
Loss Adjust Expense Paid to Defense Counsel $66,766
All Other Loss Adjustment Expense Paid $4,168
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 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

This page is not displaying certain sensitive information.

Court Case # 0612212CA02

Indemnity Paid: $25,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200745005
Claim Number :33531-01
Date Submitted :3/29/2007
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCheriMMontague
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJORGEVANTUNEZ-DE-MAYOLO V
Insurer TypeStreet Address of Practice
Licensed3661 South Miami Avenue
CityStateZip CodeCounty
MiamiFL33133Dade
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
98909$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME47826Oncology - no surgery80259

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDade
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
7/28/200512/22/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Adenocarcinoma of the left breast.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Unnecessary adjuvant chemotherapy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Loss of hair and side effects from the chemotherapy.
Severity Of Injury
Temporary: Slight - Lacerations, contusions, minor scars, rash.No delay.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/27/20060612212CA02
County Suit Filed inDate of Final Disposition
Dade3/9/2007
Other Defendants Involved in this Claim
 
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
3/9/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$25,000
Loss Adjust Expense Paid to Defense Counsel$5,940
All Other Loss Adjustment Expense Paid$5,697
Injured Person's Total Non-Economic Loss$25,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.
 
Updates
 
No updates found.

 

 

This page is not displaying certain sensitive information.

Court Case #

Indemnity Paid: $0.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201576511
Claim Number : 330555
Date Submitted : 12/10/2015
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual AUDRA M FLOYD
Street Address
13450 WEST SUNRISE BLVD
City State Zip
SUNRISE FL 33323
Phone Ext Fax E-Mail Address
(877) 320 - 0748 3111 (866) 636 - 5421 afloyd@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual JORGE C ANTUNEZ-DE-MAYOLO V
Insurer Type Street Address of Practice
Licensed 3659 South Miami Avenue, Ste. #2001
City State Zip Code County
Coconut Grove FL 33133 Dade
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0884139 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME47826 Hematology - No 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 Dade
City State Zip Code
     
Location where injury occured Other location where injury occured
Patient's Home  
Name of Institution Code
N/A 000000
Location of Institutional Injury Other Location of Institutional Injury
Other Patient's Home
Date of Occurrence Date Reported to Insurer
1/12/2012 6/2/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Aneurysm in leg.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
None.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Left leg amputation.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
  *NR
County Suit Filed in Date of Final Disposition
*NR 12/8/2015
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
No Payment Made
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? No
Indemnity Paid by Insurer on behalf of Insured $0
Loss Adjust Expense Paid to Defense Counsel $11,000
All Other Loss Adjustment Expense Paid $0
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 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured has consulted with defense counsel and claims personnel.
 
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.

Alachua Baker Bay Bradford Brevard Broward Calhoun Charlotte Citrus Clay Collier Columbia Dade Desoto Dixie Duval Escambia Flagler Franklin Gadsden Hamilton Hardee Hendry Hernando Highlands Hillsborough Indian River Jackson Lake Lee Leon Levy Madison Manatee Marion Martin Monroe Nassau Okaloosa Okeechobee Orange Osceola Out of state Palm Beach Pasco Pinellas Polk Putnam Santa Rosa Sarasota Seminole St. Johns St. Lucie Sumter Suwannee Taylor Volusia Walton