Medical Malpractice Cases

Dr. Nicholas Blavatsky Medical Malpractice Cases

Court Case # GCG-01-1657

Indemnity Paid: $99,999.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535452
Claim Number :211911
Date Submitted :6/9/2005
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJosie  Maldonado
Street Address
The Doctors Company, 13450 West Sunrise Blvd., Suite 160
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(954) 858 - 0480 (954) 838 - 4780JMaldonado@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualNicholas Blavatsky
Insurer TypeStreet Address of Practice
Licensed225 S CLARK ST
CityStateZip CodeCounty
BUTTEMT59701-1515Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
027791$2,000,000$5,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME48414Surgery - Orthopedic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WINTER HAVEN HOSPITAL100052
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
10/27/199812/18/2000
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pain in right hip with marked reduction in abduction of the hip.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Total hip revision
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Total hip revision due to a malpoisitioned acetabular prosthesis
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/27/2001GCG-01-1657
County Suit Filed inDate of Final Disposition
Polk5/19/2005
Other Defendants Involved in this Claim
Glesser Clinic
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
5/24/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$99,999
Loss Adjust Expense Paid to Defense Counsel$0
All Other Loss Adjustment Expense Paid$90,000
Injured Person's Total Non-Economic Loss$0
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
Unknown
 
Updates
 
No updates found.

 

 

*NR:Prior to 04/28/1999 this field was not required in submitted claims.

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