Dr. Peter P Zabinski Medical Malpractice Cases

Court Case # 05-2009-CA-14231

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M201365842
Claim Number :	16106S/28508
Date Submitted :	3/6/2013

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			Zabinski
Insurer Type		Street Address of Practice
Licensed		200 E. Sheridan Road
City		State	Zip Code	County
Melbourne		FL	32901	Brevard
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600401 05		$500,000		$1,500,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME33146		Surgery - Urological

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	Brevard
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
HOLMES REGIONAL MEDICAL CENTER		100019
Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
8/14/2007		8/28/2007

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Staghorn calculus
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right percutaneous nephrolithotomy
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely recognize and treat acute intra-abdominal hemorrhage
Principal Injury Giving Rise To The Claim
Right nephrectomy
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 Suit			Circuit Court Case Number
2/16/2009			05-2009-CA-14231
County Suit Filed in			Date of Final Disposition
Brevard			1/16/2013
Other Defendants Involved in this Claim
Abad, MD, Fernando Bryant, MD, John Melbourne Internal Medicine Associates St. George, MD, James Health First Physicians Schrader, MD, Keith Coppala, CRNA, Eric Henderson, CRNA, Amanda Butler, CRNA, Rebecca Brevard Anesthesia Services
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
12/21/2012

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

$158,585

All Other Loss Adjustment Expense Paid

$131,233

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$618,212	$1,249,928
Wage Loss	$9,000	$176,852
Other Expenses	$0	$0

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Risk management has counseled insured

Updates

Date of Change:

3/6/2013 4:27:21 PM

Reason for Change:

Report updated to reflect Court Document final disposition date of 1/16/13

Field Changed	Former Value	New Value
Date of Final Disposition	21-DEC-12	16-JAN-13

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Court Case # 05-2002-CA-005974

Indemnity Paid: $75,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M200848698
Claim Number :	E29437
Date Submitted :	8/12/2009

Insurer Information

Insurer Name				Coverage Type
PROASSURANCE CASUALTY COMPANY				Primary
Insurer FEIN		Professional License Number
38-2317569
Insurer Contact Information
Type		Entity Name
Entity		ProAssurance Indemnity Company, Inc.
Street Address
13919 Carrollwood Village Run
City				State	Zip
Tampa				FL	33618-2746
Phone	Ext	Fax	E-Mail Address
(813) 969 - 2010		(813) 969 - 2120	SNorris@ProAssurance.com

Insured Information

Type	First Name		MI	Last Name
Individual	Peter		P	Zabinski
Insurer Type		Street Address of Practice
Licensed		1318 Pine Street
City		State	Zip Code	County
Melbourne		FL	32901	Brevard
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PNFL-1003274-01		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME33146		Surgery - Urological		00000

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Brevard
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
HOLMES REGIONAL MEDICAL CENTER		100019
Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
6/24/2000		7/31/2000

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Renal/adrenal mass.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Laparoscopic nephrectomy.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose perforated colon.
Principal Injury Giving Rise To The Claim
Death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
10/16/2002			05-2002-CA-005974
County Suit Filed in			Date of Final Disposition
Brevard			2/4/2008
Other Defendants Involved in this Claim
Holmes Regional Medical Center Piecewicz, Angela Weso, Kimberly Oliver-Green, Krystal Porter, Jean Rice, Kellie J McAllister, Melvin D Fried, June D Cherin, Harris Radiology Associates of Brevard Chandra, Rajiv Chandra, Gayden & Patel Brevard Physicians Group Gurri, Joseph MIMA Services, Inc. Goldberg, Stephen E Saracino, Anthony Fields, Thomas D Khair-El-Din, Tarik A Boone, Charles H Jessup, John G Omni Health-Care, P.A. Mateos-Mora, Miguel Osler Medical, P.A.
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
2/19/2008

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$75,000

Loss Adjust Expense Paid to Defense Counsel

$143,195

All Other Loss Adjustment Expense Paid

$86,011

Injured Person's Total Non-Economic Loss

$75,000

Deductible

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 discussed case with insurance company personnel, medical experts and defense counsel.

Updates

Date of Change:

6/11/2008 11:36:55 AM

Reason for Change:

Report updated to reflect additional legal fees and expenses paid.

Field Changed	Former Value	New Value
All Other Loss Adjustment Expense Paid	65044	85997
Amount of Loss Adjustment Expense Paid to Defense Counsel	126877	143178

Date of Change:

8/12/2009 9:11:02 AM

Reason for Change:

Report updated to reflect additional legal fees and expenses paid.

Field Changed	Former Value	New Value
All Other Loss Adjustment Expense Paid	85997	86011
Amount of Loss Adjustment Expense Paid to Defense Counsel	143178	143195

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