Dr. VISHTASB BROUMAND, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. VISHTASB BROUMAND, MD

20423 State Road 7, Suite F18

Indemnity Paid: $68,000.00

Insurer Information

Insurer Name				Coverage Type
OMS NATIONAL INSURANCE COMPANY, RISK RETENTION GROUP				Primary
Insurer FEIN		Professional License Number
36-3571664
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Janet		L	Meyer
Street Address
6133 North River Road, Suite 650
City				State	Zip
Rosemont				IL	60018
Phone	Ext	Fax	E-Mail Address
(847) 653 - 8823		(847) 653 - 8485	janet.meyer@fortressins.com

Insured Information

Type	First Name		MI	Last Name
Individual	Vishtasb			Broumand
Insurer Type		Street Address of Practice
Licensed		20423 State Road 7, Suite F18
City		State	Zip Code	County
Boca Raton		FL	33498	Volusia
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
24649		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Dentistry
License Number		Specialty Code & Classification		Certification Number
DN14533		Dentists - Engaged in oral surgery or operative dentistry on patients rendered unconscious through the administering of any anesthesia or analgesia

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Volusia
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
8/25/2010		12/1/2010

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Due to a complication of her previously diagnosed Wegener's Granulomatosis and as a result of the innocuous act of blowing her nose the patient had developed a fistula in the roof of her mouth. The patient presented to the insured for immediate treatment.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured attempted to repair the fistula performing a primary closure and utilizing alloderm. The closure was unsuccessful and the patient went on to have an additional procedure.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
The patient alleges that the insured's surgical procedure failed requiring her to undergo additional surgical treatment.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Legal Information

Date of Suit			Circuit Court Case Number
8/9/2012			2012-32158-CICI
County Suit Filed in			Date of Final Disposition
Volusia			6/11/2013
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
7/19/2013

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$68,000

Loss Adjust Expense Paid to Defense Counsel

$18,315

All Other Loss Adjustment Expense Paid

$2,708

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

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

Unknown

*NR:Prior to 04/28/1999 this field was not required in submitted claims.

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Does Dr. VISHTASB BROUMAND, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. VISHTASB BROUMAND, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).