| Department File Number : | M201573409 |
| Claim Number : | 13-0067-A-12 |
| Date Submitted : | 1/7/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| FD INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-3704679 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Tamla | Lloyd | |||
| Street Address | |||||
| 4651 Salisbury Road, Suite 410 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32256 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 296 - 2887 | 212 | (904) 296 - 1245 | tlloyd@fdinsurancecompany.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Raymond | Hautamaki | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2130 S. Tamiami Trail | ||||
| City | State | Zip Code | County | ||
| Sarasota | FL | 34239 | Sarasota | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MS001012 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME59585 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Sarasota | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Physician's Office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 12/22/2012 | 3/6/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient was presented on 12/19/12 with cough and again on 12/22/12 with chest congestion. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| None shown | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| None made | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Dr. Hautamaki allegedly did not explain to or warn the patient that Levaquin, coupled with steroids, could cause pain, cramping , tears.tendonitis and tendon tears. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/25/2014 | 2014-CA-001685 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Sarasota | 1/9/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Todd K. Hortuchi, MD, LLC Hautamaki & Horiuchi, LLC Horiuchi, Todd R. Dean Hautamaki, MD, PA | |||||
| 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 | |||||
| 1/9/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $32,500 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $20,766 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Circumstances of this case have been discussed with insured and Risk Management was notified. Risk management has discussed with insured. | |||||||||||||||||||||
| Updates | |||||||
| Date of Change: | 1/7/2016 2:18:54 PM | ||||||
| Reason for Change: | Final LAE amount changed. | ||||||
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Does Dr. RAYMOND HAUTAMAKI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RAYMOND HAUTAMAKI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).