Department File Number : | M201574755 |
Claim Number : | 2013-09-202-001 |
Date Submitted : | 5/29/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LEXINGTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-114949 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Amy | A | Villareal | ||
Street Address | |||||
16255 Bay Vista Drive | |||||
City | State | Zip | |||
Tampa | FL | 33760 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 519 - 1274 | amy.villareal@baycare.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Stephen | Wagner | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 505 Oakfield Drive | ||||
City | State | Zip Code | County | ||
Brandon | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
112-31-715 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME15542 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/23/2012 | 4/17/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to the MD's office seeking tubal ligation. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Laparoscopic bilateral tubal ligation | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to detect perforation in the mid-small bowel at the time of the tubal ligation. | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient, who was diabetic, returned to the hospital the day after the tubal ligation with severe pain, nausea, vomiting, and ketoacidosis. Surgery was consulted and the patient was taken for exploratory laparotomy. A small perforation of the mid-small bowel was noted, as well as extensive abdominal adhesions. A portion of bowel was resected. The patient had a prolonged hospital admission, including management of her diabetes and a return to surgery for resection of a small bowel fistula and debridement of the inferior portion of the wound. | |||||
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 | ||||
7/22/2013 | 13-CA-009513 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 5/12/2015 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
5/12/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $95,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $57,691 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Any risk issues have been/will be addressed. |
Updates | |
No updates found. |
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Does Dr. STEPHEN WAGNER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. STEPHEN WAGNER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).