Department File Number : | M201782459 |
Claim Number : | 106696 |
Date Submitted : | 6/29/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
OPHTHALMIC MUTUAL INSURANCE COMPANY (A R.R.G.) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
94-3047990 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MARITZA | MORENO | |||
Street Address | |||||
PO Box 140457 | |||||
City | State | Zip | |||
Coral Gables | FL | 33114 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 503 - 5704 | (888) 909 - 5304 | MMORENO@MRCG.ORG |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Martin | E | Orlick | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5800 49th Street North | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33701 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
OMC0010699 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME51975 | Surgery - Opthalmology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
NORTHSIDE HOSPITAL | 100238 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/2/2011 | 5/9/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Macular hole, left eye | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent retinal surgery by insured for repair of a central macular hole. Postoperatively the patient had diminished vision. Plaintiff alleged improper use of anesthesia caused injury to the optic nerve, however, subsequent evaluations failed to discovery injury to the optic nerve. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis made. The patient required surgery to repair the macular hole. | |||||
Principal Injury Giving Rise To The Claim | |||||
Loss of vision, left eye. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/27/2013 | 13-010617 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 5/19/2017 | ||||
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 Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
5/24/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $175,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Care provided was reviewed by medical experts who found there was no negligence on the part of the insured. |
Updates | |
No updates found. |
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Does Dr. MARTIN E ORLICK, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARTIN E ORLICK, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).