Department File Number : | M201575530 |
Claim Number : | FP4013502 |
Date Submitted : | 8/13/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Vladimir | Mathieu | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1121 Health Park Blvd. | ||||
City | State | Zip Code | County | ||
Naples | FL | 34110 | Collier | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-CL099219 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79564 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Collier | ||||
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 | ||||
Other | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/3/2011 | 2/10/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Fluid detention; diabetes mellitus; hypertension, peripheral vascular disease and obesity. Non compliance with insulin and oral diabetes medications and others. When patient complained of increased fluid retention, patient failed to come to office or clinic. Physician ordered lasix and instructed to go to ER if needed. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Pharmacy duplicated antidiabetic oral meds which may increase fluid retention and failed to dispense lasix. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Plaintiff found deceased in AM; medical examiner opioned death from complications of CHF, contributed to 5 year ASHD & diabetes management | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/5/2012 | 12CA4327 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Collier | 7/1/2015 | ||||
Other Defendants Involved in this Claim | |||||
American Discount Pharmacy Group | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $400,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $83,263 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $77,159 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
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 : | M201782650 |
Claim Number : | 1022127-01 |
Date Submitted : | 8/22/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Vladimir | J | Mathieu | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 400 8th St N | ||||
City | State | Zip Code | County | ||
Naples | FL | 34102 | Collier | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
651996 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79564 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Collier | ||||
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 | ||||
5/31/2014 | 11/6/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Malaise including strep throat | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Antibiotics and steroids | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to properly treat | |||||
Principal Injury Giving Rise To The Claim | |||||
Death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/12/2015 | 11-2015-CA-001479-00 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Collier | 7/12/2017 | ||||
Other Defendants Involved in this Claim | |||||
Zelahy, John W Healy-Fetter, Jennifer NCH Healthcare System Inc Millennium Physician Group LLC Thse-Marco Urgent Care LLC | |||||
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 | |||||
7/12/2017 |
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 | $90,055 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $39,777 | ||||||||||||||||||||
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 | |||||||||||||||||||||
n/a |
Updates | ||||||||||
Date of Change: | 7/21/2017 4:07:58 PM | |||||||||
Reason for Change: | Plaintiff name misspelled | |||||||||
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Date of Change: | 1/31/2018 4:07:44 PM | |||||||||
Reason for Change: | ALE UPDATE 1/31/2018 | |||||||||
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Date of Change: | 8/22/2018 11:22:43 AM | |||||||||
Reason for Change: | ALE UPDATE | |||||||||
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Does Dr. VLADIMIR MATHIEU, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. VLADIMIR MATHIEU, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).