Medical Malpractice Cases

Medical Malpractice Cases In Brevard County Florida

Dr. ROBERTO G MIXCO Medical Malpractice Lawsuits - Court Case # 05-2004-CA-0111412

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200641636
Claim Number :502290
Date Submitted :7/19/2006
 
Insurer Information
 
Insurer NameCoverage Type
AMERICAN HEALTHCARE INDEMNITY COMPANYPrimary
Insurer FEINProfessional License Number
59-2048400 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDeborah AFuller
Street Address
1888 Century Park East, #800
CityStateZip
Los Angeles CA90067
PhoneExtFaxE-Mail Address
(310) 556 - 7414  dfuller@scpie.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualROBERTOGMIXCO
Insurer TypeStreet Address of Practice
Licensed1395 N. Courtenay Pkwy. #106
CityStateZip CodeCounty
Merritt Island FL32953Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
25182213$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME50063Neurology - Including Child - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CAPE CANAVERAL HOSPITAL100177
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
10/12/20029/26/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Possible stroke
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Brain CT
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis made
Principal Injury Giving Rise To The Claim
Alleged negligent management of patient diagnosed with small stroke following brain CT.Patient subsequently developed massive cerebellar stroke and hydrocephalus, resulting in brain injury.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/5/200405-2004-CA-0111412
County Suit Filed inDate of Final Disposition
Brevard6/23/2006
Other Defendants Involved in this Claim
Cape Canaveral Hospital (litigation pending)
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/23/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$34,302
All Other Loss Adjustment Expense Paid$15,916
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$2,400,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
No updates found.

 

 

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Dr. Stanley W Tenenbaum Medical Malpractice Lawsuits - Court Case # 05-2006-CA-13749

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643017
Claim Number :00061
Date Submitted :11/2/2006
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualMARITZA MORENO
Street Address
2655 LeJeune Road, Suite 803
CityStateZip
Coral GablesFL33134
PhoneExtFaxE-Mail Address
(305) 447 - 4513 (305) 447 - 4514MMORENO@MRCG.ORG
 
Insured Information
 
TypeFirst NameMILast Name
IndividualStanleyWTenenbaum
Insurer TypeStreet Address of Practice
Licensed189 NW 113th Way
CityStateZip CodeCounty
Coral SpringsFL33071Broward
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1064385823-0$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME43535Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
WUESTHOFF MEMORIAL HOSPITAL23960034
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
5/7/200512/27/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient sought treatment for intermittent spots in her right peripheral vision accompanied by weakness during the episodes.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient seen in the ER with a 2 day history of intermittent impaired speech with dizziness categorized as mild.She was diagnosed with high blood pressure and TIA and told to follow-up with her primary physician.The patient subsequently suffered a CVA.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Patient in vegetative state as a result of massive CVA.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/25/200605-2006-CA-13749
County Suit Filed inDate of Final Disposition
Brevard10/30/2006
Other Defendants Involved in this Claim
Wuesthoff Memorial Hospital
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/19/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$12,982
All Other Loss Adjustment Expense Paid$14,907
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured discussed case with medical experts and insurance carrier personnel.
 
Updates
 
No updates found.

 

 

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Dr. Joseph A Sterling Medical Malpractice Lawsuits - Court Case # 05-2004-CA-18363

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200850453
Claim Number :18086-01
Date Submitted :8/7/2008
 
Insurer Information
 
Insurer NameCoverage Type
AMERICAN PHYSICIANS ASSURANCE CORPORATIONPrimary
Insurer FEINProfessional License Number
38-2102867 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualBarbaraAEvans
Street Address
1301 N. Hagadorn Road
CityStateZip
East LansingMI48823
PhoneExtFaxE-Mail Address
(517) 324 - 6570 (517) 333 - 2806bevans@apassurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJosephASterling
Insurer TypeStreet Address of Practice
Licensed1340 Medical Park Drive, Suite 100
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
126767$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME55570Anesthesiology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityHealthSouth Melbourne Surgery Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
8/31/20019/12/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Repair of torn right rotator cuff.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured physician was supervising the CRNA who was actually performing the anesthesia responsibilities.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged premature extubation
Principal Injury Giving Rise To The Claim
Death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/26/200405-2004-CA-18363
County Suit Filed inDate of Final Disposition
Brevard7/31/2008
Other Defendants Involved in this Claim
Melbourne Surgery Center, L.P.
d/b/a HealthSouth Melbourne Surgery Center
Thorpe, Linda J
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/11/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$199,552
All Other Loss Adjustment Expense Paid$60,843
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured consulted with claims personnel and defense counsel.$1,000,000 was paid in full and final settlement of all claims on behalf of the insured.
 
Updates
 
No updates found.

 

 

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Dr. Pachavit Kasemsap Medical Malpractice Lawsuits - Court Case # 10-CA-12322

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201162030
Claim Number :29738
Date Submitted :10/27/2011
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPachavit Kasemsap
Insurer TypeStreet Address of Practice
Licensed12682 NW 32nd Place, 108-3
CityStateZip CodeCounty
SunriseFL33323Broward
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600940 06$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME87867Surgery - General 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilitySame Day Surgery
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
2/12/20092/25/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Gallbladder disease
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Laparoscopic cholecystectomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Laceration of aorta
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/5/201010-CA-12322
County Suit Filed inDate of Final Disposition
Brevard10/21/2011
Other Defendants Involved in this Claim
Osler Medical
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/21/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$23,800
All Other Loss Adjustment Expense Paid$14,963
Injured Person's Total Non-Economic Loss$0
Deductible$100,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$533,576$0
Wage Loss$0$0
Other Expenses$7,894$300,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. Peter Zabinski Medical Malpractice Lawsuits - Court Case # 05-2009-CA-14231

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201365842
Claim Number :16106S/28508
Date Submitted :3/6/2013
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPeter Zabinski
Insurer TypeStreet Address of Practice
Licensed200 E. Sheridan Road
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600401 05$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME33146Surgery - Urological 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
8/14/20078/28/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Staghorn calculus
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right percutaneous nephrolithotomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely recognize and treat acute intra-abdominal hemorrhage
Principal Injury Giving Rise To The Claim
Right nephrectomy
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/16/200905-2009-CA-14231
County Suit Filed inDate of Final Disposition
Brevard1/16/2013
Other Defendants Involved in this Claim
Abad, MD, Fernando
Bryant, MD, John
Melbourne Internal Medicine Associates
St. George, MD, James
Health First Physicians
Schrader, MD, Keith
Coppala, CRNA, Eric
Henderson, CRNA, Amanda
Butler, CRNA, Rebecca
Brevard Anesthesia Services
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/21/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$158,585
All Other Loss Adjustment Expense Paid$131,233
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$618,212$1,249,928
Wage Loss$9,000$176,852
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:3/6/2013 4:27:21 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 1/16/13
 
Field ChangedFormer ValueNew Value
Date of Final Disposition21-DEC-1216-JAN-13

 

 

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Dr. FREDERICK WARD Medical Malpractice Lawsuits - Court Case # 05-2013-CA-025059

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470933
Claim Number :FP4326701
Date Submitted :6/3/2014
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKelly Andrews
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(904) 360 - 3038  kandrews@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualFREDERICK WARD
Insurer TypeStreet Address of Practice
Licensed10728 Bella Lago Drive
CityStateZip CodeCounty
OrlandoFL32832Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
CL106875$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85924Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WUESTHOFF MEMORIAL HOSPITAL, INC.100092
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/23/20126/26/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Large ischemic infarct in the left ganglia, left corona radiate and partial thrombosis of the left intracranial carotid artery & occlusion of the left middle cerebral artery.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient was baker acted.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
The patient was baker acted.
Principal Injury Giving Rise To The Claim
Acute left hemisphere CVA.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/2/201305-2013-CA-025059
County Suit Filed inDate of Final Disposition
Brevard5/29/2014
Other Defendants Involved in this Claim
Floridian Emergency Specialists, LLC
Wuesthoff Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/29/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$55,308
All Other Loss Adjustment Expense Paid$10,301
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
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.

 

 

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Dr. Geetha Priyanka Medical Malpractice Lawsuits - Court Case # 2012-CA-24901

Indemnity Paid: $900,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201471414
Claim Number :36752
Date Submitted :7/25/2014
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGeetha Priyanka
Insurer TypeStreet Address of Practice
Licensed948 S. Wickham Rd., Ste. 103
CityStateZip CodeCounty
West MelbourneFL32904Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601134 08$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78873Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
11/5/20092/28/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Prostate cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged 13-month delay in diagnosis of prostate cancer due to clerical filing error
Principal Injury Giving Rise To The Claim
Prostate cancer
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/9/20122012-CA-24901
County Suit Filed inDate of Final Disposition
Brevard7/14/2014
Other Defendants Involved in this Claim
Baba Health Care, Inc.
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/2/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$900,000
Loss Adjust Expense Paid to Defense Counsel$52,389
All Other Loss Adjustment Expense Paid$25,003
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$195,126$0
Wage Loss$0$0
Other Expenses$0$250,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. WAYNE S BARRY Medical Malpractice Lawsuits - Court Case # 05-2002-CA-007058

Indemnity Paid: $880,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746310
Claim Number :40-006142
Date Submitted :7/19/2007
 
Insurer Information
 
Insurer NameCoverage Type
TRUCK INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
95-2575892 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualVernie Shirley
Street Address
700 South Flower Street, Suite 2700
CityStateZip
Los AngelesCA90017
PhoneExtFaxE-Mail Address
(213) 615 - 2682  vern.shirley@farmersinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualWAYNESBARRY
Insurer TypeStreet Address of Practice
LicensedC/O FLORIDA HOSPITAL FISH MEMO 1055 SAXON BLVD
CityStateZip CodeCounty
ORANGE CITYFL32763Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
1177-7613$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME51146Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other LocationBabby Sitters house
Name of InstitutionCode
PARRISH MEDICAL CENTER100028
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
12/2/20003/9/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Seizure
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Emergency intubation
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly intubate
Principal Injury Giving Rise To The Claim
Death from complications of hypoxic encephalopathy following seizures and bilateral pneumonia
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
11/20/200205-2002-CA-007058
County Suit Filed inDate of Final Disposition
Brevard7/16/2007
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/19/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$880,000
Loss Adjust Expense Paid to Defense Counsel$93,084
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
No Risk Management Services Provided.
 
Updates
 
No updates found.

 

 

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Dr. RONALD H THOMPSON Medical Malpractice Lawsuits - Court Case # 05-2001-CA-020375

Indemnity Paid: $878,828.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535081
Claim Number :A01-24173-00
Date Submitted :5/3/2005
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCheriMMontague
Street Address
1000 Riverside Drive, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRONALDHTHOMPSON
Insurer TypeStreet Address of Practice
Licensed330 E. Hibiscus Blvd.
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
27664$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME71086Surgery - Obstetrics - Gynecology80153

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
7/30/20006/12/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient had severe pelvic inflammatory disease with two forms of bacteria that had the potential to progress to sepsis and death. The fallopian tubes were obliterated and there were bilateral ovarian abscesses and also peritonitis due to the advance stage of the disease.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Hysterectomy and bilateral salpingo-oophorectomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Our gynecological expert, who specializes in gynecological infectious disease, was of the opinion that this was a chronic process, and also that the condition of the ovaries, tubes and uterus at the time of the surgery would have resulted in infertility, even if hysterectomy had not been performed.
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
11/5/200105-2001-CA-020375
County Suit Filed inDate of Final Disposition
Brevard4/5/2005
Other Defendants Involved in this Claim
Hibiscus OB/GYN Physicians, P.A.
Stage of Legal System at which Settlement was Reached or Award Made
After appeal.
Final Method of Claim Disposition
Disposed of by Court
Court DecisionOther
Judgment for the plaintiff after appeal ... 
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/5/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$878,828
Loss Adjust Expense Paid to Defense Counsel$110,723
All Other Loss Adjustment Expense Paid$45,411
Injured Person's Total Non-Economic Loss$700,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$40,861$50,918
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
In our opinion, no risk management is necessary. The trial judge failed to allow our expert to address the critictisms and limited the defense of the case. The insurance coverage for Dr. Thompson, the defendant physician, was processed through the insurance policy of Dr. Wagaman, as the employer of Dr. Thompson. However, Dr. Wagaman was not a participant in medical care or a defendant.
 
Updates
 
No updates found.

 

 

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Dr. Pachavit Kasemsap Medical Malpractice Lawsuits - Court Case # 05-2012-CA-038840

Indemnity Paid: $875,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201368631
Claim Number :32705
Date Submitted :10/14/2013
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPachavit Kasemsap
Insurer TypeStreet Address of Practice
Licensed930 S. Harbor City Blvd.
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600939 07$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME87867Surgery - General 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WUESTHOFF MEMORIAL HOSPITAL23960034
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
11/2/20091/6/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Weight reduction
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Gastric lap-band
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to appropriately perform procedure and provide appropriate follow-up care
Principal Injury Giving Rise To The Claim
Stomach perforation
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/29/201205-2012-CA-038840
County Suit Filed inDate of Final Disposition
Brevard9/18/2013
Other Defendants Involved in this Claim
Osler Medical
Wuesthoff Medical Center
Holmes Regional Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/18/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$875,000
Loss Adjust Expense Paid to Defense Counsel$25,643
All Other Loss Adjustment Expense Paid$11,422
Injured Person's Total Non-Economic Loss$0
Deductible$100,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$469,911$0
Wage Loss$0$630,000
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. MARILYN C MOSS Medical Malpractice Lawsuits - Court Case # 05-2003-CA44388

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747345
Claim Number :267260
Date Submitted :2/5/2009
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualMary Osborn
Street Address
5814 Reed Rd
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(800) 463 - 37766604(260) 486 - 0785Mary.Osborn@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMARILYNCMOSS
Insurer TypeStreet Address of Practice
Licensed3210 N WICKHAM RD STE 1
CityStateZip CodeCounty
MELBOURNEFL32935-2342Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
617408$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME22466Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
11/27/20002/8/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
PAIN IN LOWER LEFT BACK
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
EMERGENCY ROOM EVALUATION & OFFICE VISITS
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAIL TO OBTAIN TIMELY DIAGNOSTIC STUDIES
Principal Injury Giving Rise To The Claim
PERMANENET CARDIAC DISABILITIES
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/2/200205-2003-CA44388
County Suit Filed inDate of Final Disposition
Brevard10/1/2007
Other Defendants Involved in this Claim
BLACKMAN, KEITH
AVETA HEALTH INC
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/10/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$750,000
Loss Adjust Expense Paid to Defense Counsel$125,497
All Other Loss Adjustment Expense Paid$68,995
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
 
Date of Change:2/5/2009 3:18:54 PM
Reason for Change:Updated ALE
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel89396125497
All Other Loss Adjustment Expense Paid6744268995

 

 

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Dr. Ronald S Sills Medical Malpractice Lawsuits - Court Case # 05-2003 CA 07 044050

Indemnity Paid: $700,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747325
Claim Number :MM 229827
Date Submitted :10/12/2007
 
Insurer Information
 
Insurer NameCoverage Type
EVANSTON INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
36-2950161 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualLindaMMurray
Street Address
Ten Parkway North, Suite 100
CityStateZip
DeerfieldIL60015
PhoneExtFaxE-Mail Address
(847) 527 - 6082 (847) 572 - 6338murray@markelcorp.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRonaldSSills
Insurer TypeStreet Address of Practice
Licensed1712 University Lane, Suite 308
CityStateZip CodeCounty
CocoaFL32922Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MM-804650$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME58336Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/2/20021/6/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Plaintiff came to ER with complaints of crampy abdominal pain and diarrhea for five days.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured physician ordered initial lab tests that included a CBC, CMP, urinalysis and fecal leukocytes and parasites.A CT Scan of the abdomen and the pelvis with contrast was ordered, IV hydration was begun.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Plaintiff had a perforated colon
Principal Injury Giving Rise To The Claim
Plaintiff died.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/5/200305-2003 CA 07 044050
County Suit Filed inDate of Final Disposition
Brevard10/11/2007
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/10/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$700,000
Loss Adjust Expense Paid to Defense Counsel$245,514
All Other Loss Adjustment Expense Paid$24,975
Injured Person's Total Non-Economic Loss$530,000
Deductible$5,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$45,000$0
Wage Loss$125,000$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
None.
 
Updates
 
No updates found.

 

 

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Dr. JUDY HOUSEL Medical Malpractice Lawsuits - Court Case # 04-CA-30896

Indemnity Paid: $600,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200849552
Claim Number :CORP-04-33807-JH
Date Submitted :5/13/2008
 
Insurer Information
 
Insurer NameCoverage Type
LEXINGTON INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
25-1149494 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancyJThomas
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJUDY HOUSEL
Insurer TypeStreet Address of Practice
Licensed3675 Audrey Drive
CityStateZip CodeCounty
TITUSVILLEFL32796Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
679-2879$1,000,000$1,000,000
Profession or BusinessOther Profession or Business
OtherARNP
License NumberSpecialty Code & ClassificationCertification Number
ARNP596042  

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
PARRISH MEDICAL CENTER100028
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
4/27/20037/9/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Meningitis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to diagnose
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose
Principal Injury Giving Rise To The Claim
Death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/29/200404-CA-30896
County Suit Filed inDate of Final Disposition
Brevard5/12/2008
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
Disposed of by Court
Court DecisionOther
OtherDISMISSED WITH PREJUDICE
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$600,000
Loss Adjust Expense Paid to Defense Counsel$33,350
All Other Loss Adjustment Expense Paid$10,405
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
UNKNOWN
 
Updates
 
No updates found.

 

 

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Dr. HILBERT C ZEBALLOS Medical Malpractice Lawsuits - Court Case # 08CA57982

Indemnity Paid: $600,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200955767
Claim Number :281928
Date Submitted :9/2/2010
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualMyra  Lassen
Street Address
5814 Reed Road
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0438  reportaclaim@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualHILBERTCZEBALLOS
Insurer TypeStreet Address of Practice
Licensed20 E MELBOURNE AVE, SUITE 104
CityStateZip CodeCounty
MELBOURNEFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
703131$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME90229Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/18/20077/15/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
SUDDEN ONSET BACK PAIN
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
SEEN IN ER AND ADMITTED TO HOSPITAL BY DR.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
ALLEGED FAILURE TO TIMELY DIAGNOSE AND TREAT LUMBAR HEMATOMA
Principal Injury Giving Rise To The Claim
PARAPLEGIA
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/2/200808CA57982
County Suit Filed inDate of Final Disposition
Brevard11/30/2009
Other Defendants Involved in this Claim
ALPHA MEDICAL PA
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/30/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$600,000
Loss Adjust Expense Paid to Defense Counsel$40,991
All Other Loss Adjustment Expense Paid$30,390
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
 
Date of Change:2/12/2010 9:27:35 AM
Reason for Change:Update Financial Info
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid2101810509
Amount of Loss Adjustment Expense Paid to Defense Counsel3581917910
 
Date of Change:9/2/2010 3:13:59 PM
Reason for Change:UPDATE FEE & EXP
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid1050930390
Amount of Loss Adjustment Expense Paid to Defense Counsel1791040991

 

 

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Dr. John P Pompura Medical Malpractice Lawsuits - Court Case # 05-2001-ca-009791

Indemnity Paid: $600,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200534239
Claim Number :HM042183NE
Date Submitted :2/2/2005
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualWilliamBEdis
Street Address
7886 Woodland Center Blvd
CityStateZip
TampaFL33614
PhoneExtFaxE-Mail Address
(813) 880 - 5123 (813) 880 - 5105William.Edis@cna.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJohnPPompura
Insurer TypeStreet Address of Practice
Licensed3018 W NEW HAVEN AVE
CityStateZip CodeCounty
MELBOURNEFL32904-3565Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
DLP35158990$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Dentistry 
License NumberSpecialty Code & ClassificationCertification Number
DN3629Dentists001

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
4/4/20008/28/2000
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
TMJ dysfunction and headaches
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
orthotic appliances and bite splint
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
none
Principal Injury Giving Rise To The Claim
teeth flared
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/12/200105-2001-ca-009791
County Suit Filed inDate of Final Disposition
Brevard10/21/2004
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/21/2004
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$600,000
Loss Adjust Expense Paid to Defense Counsel$119,956
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Earlier referral to specialists will be done.
 
Updates
 
No updates found.

 

 

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Dr. Kevin B Chapin Medical Malpractice Lawsuits - Court Case # 2006-CA-013240

Indemnity Paid: $550,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200745438
Claim Number :23066
Date Submitted :5/2/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualKevinBChapin
Insurer TypeStreet Address of Practice
Licensed1281 S HICKORY ST
CityStateZip CodeCounty
MELBOURNEFL32901-3231Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600163 06$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS4658Cardiovascular Disease - Minor Surgery3575

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/12/200511/21/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest pain, shortness of breath
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :410.9
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in obtaining cardiac consult and diagnosing impending MI
Principal Injury Giving Rise To The Claim
MI and heart damage
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/30/20062006-CA-013240
County Suit Filed inDate of Final Disposition
Brevard4/13/2007
Other Defendants Involved in this Claim
Gayed, M.D., Esmat
Holmes Regional Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/25/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$550,000
Loss Adjust Expense Paid to Defense Counsel$34,812
All Other Loss Adjustment Expense Paid$24,448
Injured Person's Total Non-Economic Loss$550,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$178,267$0
Wage Loss$0$350,000
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. Raymond D Adamcik Medical Malpractice Lawsuits - Court Case # 05-2006-CA-34372

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747302
Claim Number :22689
Date Submitted :10/22/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRaymondDAdamcik
Insurer TypeStreet Address of Practice
Licensed200 East Sheridan Road
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600401 02$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME71737Internal Medicine - No Surgery512

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
12/15/200312/19/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Transient ischemic attack
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :436.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis and treatment of stroke
Principal Injury Giving Rise To The Claim
Right hemiplegia
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/19/200605-2006-CA-34372
County Suit Filed inDate of Final Disposition
Brevard10/15/2007
Other Defendants Involved in this Claim
Holmes Regional Medical Center
Melbourne Internal Medicine Associates
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/4/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$55,506
All Other Loss Adjustment Expense Paid$15,107
Injured Person's Total Non-Economic Loss$500,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$121,573$3,700,000
Wage Loss$0$380,638
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:10/22/2007 11:59:55 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 10/15/07
 
Field ChangedFormer ValueNew Value
Date of Final Disposition24-SEP-0715-OCT-07

 

 

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Dr. Fairuz Matuk Medical Malpractice Lawsuits - Court Case # 052009CA10891

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201263939
Claim Number :35373-01
Date Submitted :5/24/2012
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualFairuz Matuk
Insurer TypeStreet Address of Practice
Licensed32 Suntree Place
CityStateZip CodeCounty
MelbourneFL32940Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
20401$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME36280Surgery - Neurology - Including Child80152

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WUESTHOFF MEMORIAL HOSPITAL, INC.100092
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
4/27/20063/1/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient sought treatment for cervical myelopathy, disc protrusion and cervical stenosis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient underwent cervical decompression and lateral internal fixation and fusion.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged negligent surgery.
Principal Injury Giving Rise To The Claim
Neurologic injuries.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/22/2009052009CA10891
County Suit Filed inDate of Final Disposition
Brevard5/3/2012
Other Defendants Involved in this Claim
El Kommos, M.D., Hani
Wuesthoff Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/3/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$120,335
All Other Loss Adjustment Expense Paid$105,128
Injured Person's Total Non-Economic Loss$500,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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Dr. James Steele Medical Malpractice Lawsuits - Court Case # 2007-CA-011984

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201059345
Claim Number :2-07-0012A
Date Submitted :12/9/2010
 
Insurer Information
 
Insurer NameCoverage Type
FLORIDA HEALTHCARE PROVIDERS INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
20-0143902 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualLinda Collins
Street Address
4655 Salisbury Road, Ste. 110
CityStateZip
JacksonvilleFL32256
PhoneExtFaxE-Mail Address
(904) 296 - 2887214(904) 394 - 7134lcollins@fldic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJames Steele
Insurer TypeStreet Address of Practice
LicensedP.O. Box 3619107
CityStateZip CodeCounty
MelbourneFL32936Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
GL01000002$500,000$1,500,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS5233Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/6/20051/31/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented with complaints of neck and laeft arm pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
CT scan was performed.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleging failure to recognize, evaluate, diagnose and treat onset of neurological finding and abnormal CT scans.
Principal Injury Giving Rise To The Claim
Permanent paralysis, loss of the use of lower extremeties, resulting from spinal abscess.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/29/20072007-CA-011984
County Suit Filed inDate of Final Disposition
Brevard12/8/2010
Other Defendants Involved in this Claim
Holmes Regional Medical Center
Brevard Emergency Services, P.A.
McMullen, PA-C, Trey
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/24/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$361,910
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Circumstances of this case have been discussed with the Insured and Risk Management was notified.Risk Mangement has discussed the case with the Insured.
 
Updates
 
No updates found.

 

 

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Dr. Julian A Kyle Medical Malpractice Lawsuits - Court Case # 05-2006-CA-013843-X

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200849562
Claim Number :142431
Date Submitted :10/23/2008
 
Insurer Information
 
Insurer NameCoverage Type
PROASSURANCE CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
38-2317569 
Insurer Contact Information
TypeEntity Name
EntityProNational Insurance Company
Street Address
13919 Carrollwood Village Run
CityStateZip
TampaFL33618-2746
PhoneExtFaxE-Mail Address
(813) 969 - 2010 (813) 969 - 2120SNorris@ProAssurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJulianAKyle
Insurer TypeStreet Address of Practice
Licensed255 Borman Drive, Suite 202
CityStateZip CodeCounty
Merritt IslandFL32953Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP41022$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME70501Cardiovascular Disease - Minor Surgery00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
CAPE CANAVERAL HOSPITAL100177
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/26/20042/10/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest, abdominal and back pain with insured advising ED physician to transfer patient to another facility but with patient instead being admitted.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Delay in transfer to perform cardiac catheterization and angioplasty.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Heart damage and decreased ejection fraction.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/16/200605-2006-CA-013843-X
County Suit Filed inDate of Final Disposition
Brevard5/2/2008
Other Defendants Involved in this Claim
Health First, Inc.
Cape Canaveral Hospital, Inc.
PHY America Physician Services, Inc.
Green, Douglas W
Chao, Maurice
Cape Heart Group, Inc.
Holmes Regional Medical Center, Inc.
Melbourne Internal Medicine Associates, P.A.
Schechtmann, Norberto
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/12/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$36,737
All Other Loss Adjustment Expense Paid$13,147
Injured Person's Total Non-Economic Loss$500,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured has discussed case with insurance company personnel, medical experts and defense counsel.
 
Updates
 
 
Date of Change:10/23/2008 3:20:08 PM
Reason for Change:Report updated to reflect additional legal fees and expenses paid.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel2994336737
All Other Loss Adjustment Expense Paid839813147

 

 

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Dr. Arthur A Arnold Medical Malpractice Lawsuits - Court Case # 05-2013-CA-034850

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470252
Claim Number :303645
Date Submitted :3/26/2014
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualTiffanyDTaylor
Street Address
13450 West Sunrise Blvd
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(877) 320 - 0748  TTaylor@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualArthurAArnold
Insurer TypeStreet Address of Practice
Licensed1395 N. Courtenay Parkway, Suite 207
CityStateZip CodeCounty
Merritt IslandFL32953Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0489567$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME67328Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
N/A000000
Location of Institutional InjuryOther Location of Institutional Injury
OtherPractitioner's Office
Date of OccurrenceDate Reported to Insurer
8/6/20092/26/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Hematuria leadind to renal cell carcinoma.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured treated the patient for hematuria.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Renal cell carcinoma.
Principal Injury Giving Rise To The Claim
Alleged failure to diagnose renal cell carcinoma.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/16/201305-2013-CA-034850
County Suit Filed inDate of Final Disposition
Brevard3/26/2014
Other Defendants Involved in this Claim
Cohen, M.D., Leona
Milarn Corporation, LLC dba Arnold Primary Care
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
3/11/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$36,810
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$265,172
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$234,828$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Unknown
 
Updates
 
No updates found.

 

 

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Dr. Bhavani Puskur Medical Malpractice Lawsuits - Court Case # 05-2009-CA-065580

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201265127
Claim Number :29474
Date Submitted :12/19/2012
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualBhavani Puskur
Insurer TypeStreet Address of Practice
Licensed1185 Talon Way
CityStateZip CodeCounty
MelbourneFL32934Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1602511 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME93837Family Physicians or General Practitioners - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/23/20071/28/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pulmonary embolism
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely diagnose pulmonary embolism
Principal Injury Giving Rise To The Claim
Pulmonary embolism
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
11/10/200905-2009-CA-065580
County Suit Filed inDate of Final Disposition
Brevard12/11/2012
Other Defendants Involved in this Claim
Archibald, ARNP, Tammy
Chandra, MD, Rajiv
St. Clair, MD, Douglas
Holmes Regional Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/5/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$523,135
All Other Loss Adjustment Expense Paid$16,105
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$6,602$0
Wage Loss$0$300,000
Other Expenses$5,719$400,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:12/19/2012 1:06:20 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 12/11/12
 
Field ChangedFormer ValueNew Value
Date of Final Disposition05-OCT-1211-DEC-12

 

 

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Dr. Rajiv Chandra Medical Malpractice Lawsuits - Court Case # 05-2009-CA-065580

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201265138
Claim Number :29475
Date Submitted :1/30/2013
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRajiv Chandra
Insurer TypeStreet Address of Practice
Licensed20 E. Melbourne Ave., #104
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1602511 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME40309Surgery - Cardiovascular Disease 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
HOLMES REGIONAL MEDICAL CENTER100019
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/23/20071/28/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pulmonary embolism
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely diagnose pulmonary embolism
Principal Injury Giving Rise To The Claim
Pulmonary embolism
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
11/10/200905-2009-CA-065580
County Suit Filed inDate of Final Disposition
Brevard12/11/2012
Other Defendants Involved in this Claim
Puskur, MD, Bhavani
Archibald, ARNP, Tammy
St. Clair, MD, Douglas
Holmes Regional Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/5/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$30,416
All Other Loss Adjustment Expense Paid$6,783
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$6,602$0
Wage Loss$0$300,000
Other Expenses$5,719$400,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:1/30/2013 1:40:20 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 12/11/12
 
Field ChangedFormer ValueNew Value
Date of Final Disposition05-OCT-1211-DEC-12

 

 

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Dr. Robert M Paige Medical Malpractice Lawsuits - Court Case # 05-CA-019963

Indemnity Paid: $498,334.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643288
Claim Number :22115
Date Submitted :2/7/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertMPaige
Insurer TypeStreet Address of Practice
Licensed200 E. Sheridan Road
CityStateZip CodeCounty
MelbourneFL32901Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600401 03$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME42214Radiology - Diagnostic - Minor Surgery1103

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityHealth First healthplex
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
10/15/20014/18/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lung cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
CT scan
Diagnostic Code :793.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis of lung cancer
Principal Injury Giving Rise To The Claim
Lung cancer
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/16/200505-CA-019963
County Suit Filed inDate of Final Disposition
Brevard1/30/2007
Other Defendants Involved in this Claim
Amgott, MD, Theodore
Clarke, MD, Thomas H
Dana, MD, Gary C
Melbourne Internal Medicine Associates
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/17/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$498,334
Loss Adjust Expense Paid to Defense Counsel$7,593
All Other Loss Adjustment Expense Paid$1,289
Injured Person's Total Non-Economic Loss$498,334
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$115,479$0
Wage Loss$0$0
Other Expenses$28,000$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:2/7/2007 2:21:35 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 01/30/07
 
Field ChangedFormer ValueNew Value
Date of Final Disposition14-NOV-0630-JAN-07

 

 

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Dr. Thomas H Clarke Medical Malpractice Lawsuits - Court Case # 05-CA-019963

Indemnity Paid: $498,333.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643289
Claim Number :22116
Date Submitted :2/13/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualThomasHClarke
Insurer TypeStreet Address of Practice
Licensed7155 S. Tropical Trail
CityStateZip CodeCounty
Merritt IslandFL32952Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601281 02$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME38347Radiology - Diagnostic - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FBrevard
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityHealth First Healthplex
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
10/15/20014/18/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lung cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
CT scan
Diagnostic Code :793.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis of lung cancer
Principal Injury Giving Rise To The Claim
Lung cancer
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/16/200505-CA-019963
County Suit Filed inDate of Final Disposition
Brevard1/30/2007
Other Defendants Involved in this Claim
Amgott, MD, Theodore
Paige, MD, Robert M
Dana, MD, Gary C
Melbourne Internal Medicine Associates
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/17/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$498,333
Loss Adjust Expense Paid to Defense Counsel$7,593
All Other Loss Adjustment Expense Paid$1,289
Injured Person's Total Non-Economic Loss$498,333
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$115,479$0
Wage Loss$0$0
Other Expenses$28,000$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:2/13/2007 11:55:31 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 1/30/07
 
Field ChangedFormer ValueNew Value
Date of Final Disposition14-NOV-0630-JAN-07

 

 

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