Department File Number : | M201782917 |
Claim Number : | 9941.247 |
Date Submitted : | 8/28/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6599936 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | L | Wallace | ||
Street Address | |||||
341 3rd Street S | |||||
City | State | Zip | |||
St. Petersburg | FL | 33701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Matthew | Couch | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 4801 49th Street N. | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33709 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
30688-17 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME102879 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | St. Petersburg General Hospital | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/27/2015 | 3/3/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Large ventral incisional hernia with loss of domain. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Bowel perforation with complicated hernia repair. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Claimed delay in identifying perforation. | |||||
Principal Injury Giving Rise To The Claim | |||||
Bowel perforation. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 8/10/2017 | ||||
Other Defendants Involved in this Claim | |||||
Pinellas Surgical Associates | |||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/10/2017 |
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 | $10,262 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Based on physician's review and positive expert review, none deemed necessary. |
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.
Department File Number : | M202091799 |
Claim Number : | 9941.275 |
Date Submitted : | 3/9/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6599936 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | L | Wallace | ||
Street Address | |||||
2727 16th Street N | |||||
City | State | Zip | |||
St. Petersburg | FL | 33704 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Matthew | H | Couch | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4801 49th Street North | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33709 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
30688-19 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME102879 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
SAINT PETERSBURG GENERAL HOSPITAL | 100180 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/7/2018 | 8/7/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Post-op (hemorrhoidectomy for large thrombosed internal hemorrhoid) bleeding. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Fetus possibly died during Dr. Couch's suture ligation of a single bleed area under general anesthesia 5 days post-initial operation. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None. | |||||
Principal Injury Giving Rise To The Claim | |||||
Fetal death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 2/26/2020 | ||||
Other Defendants Involved in this Claim | |||||
St. Petersburg General Hospital (nursing care) Pile, M.D., Nadia (OB/GYN) | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
2/26/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $13,173 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Based on positive expert review by both a Board-certified surgeon and obstetrician as to the general surgeon addressing the mother's immediate needs, no steps deemed necessary. |
Updates | |
No updates found. |
Department File Number : | M201987589 |
Claim Number : | 15003/11979 |
Date Submitted : | 1/11/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6599936 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | L | Wallace | ||
Street Address | |||||
341 3rd Street S | |||||
City | State | Zip | |||
St. Petersburg | FL | 33701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Matthew | H | Couch | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4801 - 49th Street North | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33709 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
30688-16 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME102879 | Surgery - General |
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 | ||||
2/15/2015 | 1/21/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Ventral hernia with herniated small bowel loops causing obstruction | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Pt. aspirated during induction of anesthesia in surgical suite | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No known misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Aspiration during anesthesia induction | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/6/2017 | 17-000096-CI-20 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 12/3/2018 | ||||
Other Defendants Involved in this Claim | |||||
TEAM HEALTH, INC. Florida Gulf-to-Bay Anes. Assoc. Galencare, Inc. d/b/a Northside Hospital Lingam, MD, Sarat | |||||
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 | |||||
12/17/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
None, surgeon not involved in induction of anesthesia |
Updates | |
No updates found. |
Does Dr. MATTHEW COUCH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MATTHEW COUCH, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).