Department File Number : | M201782660 |
Claim Number : | 37131-1 |
Date Submitted : | 7/24/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LANCET INDEMNITY RISK RETENTION GROUP INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
26-1479165 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christopher | Teter | |||
Street Address | |||||
2810 West St. Isabel Street Suite 100 | |||||
City | State | Zip | |||
Tampa | FL | 33602 | |||
Phone | Ext | Fax | E-Mail Address | ||
(813) 290 - 8282 | 265 | cteter@lancetindemnity.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | William | Capo | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6101 WEBB ROAD SUITE 106 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33615 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
LR091296001337 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME68087 | Cardiovascular Disease - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | Tampa Community Hospital | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/14/2014 | 11/26/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Treatment was sought for pain in left neck and shoulder. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Claimant had a septic shoulder and underwent surgery. A cardiology consult was requested post surgery but the TEE machine was not working. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged improper discharge of a patient prior to securing a working TEE. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/16/2016 | 16-CA-011472 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 6/23/2017 | ||||
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 | |||||
6/23/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $21,420 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurer is unaware of what steps have been taken. |
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 : | M201574633 |
Claim Number : | 2009-31-01-00035 |
Date Submitted : | 5/14/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS INDEMNITY RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-5245060 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jaclyn | S | Adler | ||
Street Address | |||||
9300 NW 14th Street | |||||
City | State | Zip | |||
Pembroke Pines | FL | 33024 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 559 - 3131 | (954) 431 - 8388 | Jadjuster2@aol.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | WILLIAM | CAPO | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6101 Webb Road Suite 106 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33614 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PIR 10056 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME68087 | Cardiovascular Disease - Minor Surgery |
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 | ||||
SAINT JOSEPH'S HOSPITAL | 100075 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/17/2008 | 7/8/2009 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Ischemic bowel/sepsis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
There was no operation, diagnostic, or treatment procedure rendered that caused an injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to timely diagnose and treat ischemic bowel resulting in death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/25/2010 | 10-006135 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 2/27/2015 | ||||
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 | |||||
2/27/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $20,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $52,962 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $20,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
None |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. WILLIAM CAPO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. WILLIAM CAPO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).