Department File Number : | M201780895 |
Claim Number : | 21934/57600 |
Date Submitted : | 1/20/2017 |
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 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Peter | J | Casella | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 205 Park Place Blvd. | ||||
City | State | Zip Code | County | ||
Kissimmee | FL | 34741 | Osceola | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1600682 01 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME52981 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Osceola | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
OSCEOLA REGIONAL HOSPITAL | 100110 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/22/2003 | 9/30/2003 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Fibroid uterus and hypermenorrhea | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Total abdominal hysterectomy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to properly perform procedure | |||||
Principal Injury Giving Rise To The Claim | |||||
Fistula and obstruction of left ureter | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/3/2005 | CA-05-MP-001620 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Osceola | 12/19/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After court verdict and prior to filing of notice of appeal. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
Judgment for the plaintiff. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/19/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $1,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $278,773 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $149,656 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |
No updates found. |
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Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
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Does Dr. PETER J CASELLA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PETER J CASELLA, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).