Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Department File Number : | M201886100 |
Claim Number : | C172967 |
Date Submitted : | 8/8/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ADMIRAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
22-2235730 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | Padilla | |||
Street Address | |||||
1000 Howard Blvd, Ste. 300 | |||||
City | State | Zip | |||
Mount Laurel | NJ | 08054 | |||
Phone | Ext | Fax | E-Mail Address | ||
(856) 505 - 8115 | dpadilla@admiralins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | THOMAS | MIXA | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5959 Central Avenue, suite 101 | ||||
City | State | Zip Code | County | ||
Saint Petersburg | FL | 33710 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EO000032983-02 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67156 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
ST ANTHONYS PHYSICIANS SURGERY CENTER | 14960519 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/30/2016 | 10/31/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Osteoarthritis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Bilateral knee replacement | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Operating room fire/third-degree burn | |||||
Principal Injury Giving Rise To The Claim | |||||
Operating room fire/third-degree burn | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 2/27/2018 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
2/13/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $19,250 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $1,568 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $10,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
None. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201783163 |
Claim Number : | HOS-MM-150014 |
Date Submitted : | 9/21/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CATLIN SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
71-6053839 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | Catlin Specialty Ins. Co. | ||||
Street Address | |||||
3340 Peachtree Rd., NE | |||||
City | State | Zip | |||
Atlanta | GA | 30326 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 241 - 6133 | paul.moore@xlcatlin.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Thomas | M | Mixa | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5959 Central Avenue, Ste 101 | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33710 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PLM-684659-0315 | $250,000 | $1,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67156 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
11/15/2013 | 2/6/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Left distal radius fracture | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Recommended physical therapy following prior closed reduction in the ER. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged development of reflex sympathetic dystrophy (RSD). | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 2/23/2017 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
Dropped before Action Filed | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $36,998 | ||||||||||||||||||||
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 | |||||||||||||||||||||
None. Claim lacked merit. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. THOMAS M MIXA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. THOMAS M MIXA, MD has at least 6 medical malpractice case(s), lawsuit(s), or complaint(s).