Medical Malpractice Cases

Medical Malpractice Cases In Citrus County Florida

Dr. HARRIETT SMITH-MCKINNEY Medical Malpractice Lawsuits - Court Case # 2007 CA 5316

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200951973
Claim Number :EMC-AO-07-70617
Date Submitted :1/6/2009
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
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
IndividualHARRIETT SMITH-MCKINNEY
Insurer TypeStreet Address of Practice
Licensed32511 Timber Lake Drive
CityStateZip CodeCounty
Mount DoraFL32759Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-5$250,000$750,000
Profession or BusinessOther Profession or Business
OtherPhysician Assistant
License NumberSpecialty Code & ClassificationCertification Number
PA2621  

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/8/20054/17/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Severe hypertension, rash
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to order more extensive testing, failure to admit
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Treatment related
Principal Injury Giving Rise To The Claim
Bilateral 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
10/15/20072007 CA 5316
County Suit Filed inDate of Final Disposition
Citrus12/31/2008
Other Defendants Involved in this Claim
Citrus 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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
11/11/2008
 
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$0
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
NA
 
Updates
 
No updates found.

 

 

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Dr. Patrick Jean Medical Malpractice Lawsuits - Court Case # 2007 CA 5316

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200951974
Claim Number :EMC-FL-07-68372
Date Submitted :1/6/2009
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
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
IndividualPatrick Jean
Insurer TypeStreet Address of Practice
Licensed3198 CR 575
CityStateZip CodeCounty
BushnellFL33513Sumter
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-5$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME38598Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/8/20054/17/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Severe hypertension, rash
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to order more extensive testing, failure to admit
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Treatment related
Principal Injury Giving Rise To The Claim
Bilateral 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
10/15/20072007 CA 5316
County Suit Filed inDate of Final Disposition
Citrus12/31/2008
Other Defendants Involved in this Claim
Citrus 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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
11/11/2008
 
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$0
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
Unknown
 
Updates
 
No updates found.

 

 

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Dr. Harold Bradfield Medical Malpractice Lawsuits - Court Case # 2010 CA 1131

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201057720
Claim Number :LTC-CAPT-93815
Date Submitted :6/28/2010
 
Insurer Information
 
Insurer NameCoverage Type
Jackson Healthcare, Inc.Primary
Insurer FEINProfessional License Number
81-0652936 
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
IndividualHarold Bradfield
Insurer TypeStreet Address of Practice
Self-Insurer4533 39th Street South
CityStateZip CodeCounty
St. PetersburgFL33711Pinellas
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
2009-2010$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78650Radiology - Diagnostic - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
4/29/200612/3/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Head injury after jumping over wall
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
CT scan reviewed by subject of this report
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose
Principal Injury Giving Rise To The Claim
Failure to diagnose brain tumor
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
2/25/20102010 CA 1131
County Suit Filed inDate of Final Disposition
Citrus6/23/2010
Other Defendants Involved in this Claim
Citrus Memorial Hospital
Stage of Legal System at which Settlement was Reached or Award Made
After court verdict and prior to filing of notice of appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Directed verdict for plaintiff. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
5/21/2010
 
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$37,019
All Other Loss Adjustment Expense Paid$1,438
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. Eric W Hirsch Medical Malpractice Lawsuits - Court Case # 2013-CA-000167A

Indemnity Paid: $495,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201368422
Claim Number :37899/41327
Date Submitted :11/26/2013
 
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
IndividualEricWHirsch
Insurer TypeStreet Address of Practice
LicensedPO Box 1990
CityStateZip CodeCounty
Crystal RiverFL34423Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1616017 02$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME95650Surgery - Orthopedic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
4/26/20116/23/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Vascular complication following knee revision surgery.
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 and treat vascular complication.
Principal Injury Giving Rise To The Claim
Above the knee amputation.
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
2/25/20132013-CA-000167A
County Suit Filed inDate of Final Disposition
Citrus11/15/2013
Other Defendants Involved in this Claim
Citrus Orthopaedic & Joint Institute
Citrus 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
9/6/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$495,000
Loss Adjust Expense Paid to Defense Counsel$24,063
All Other Loss Adjustment Expense Paid$11,050
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$305,000$0
Wage Loss$0$0
Other Expenses$0$400,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured.
 
Updates
 
 
Date of Change:11/26/2013 11:49:50 AM
Reason for Change:Report udpated to reflect Court Document final disposition date of 11/15/13
 
Field ChangedFormer ValueNew Value
Date of Final Disposition06-SEP-1315-NOV-13

 

 

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Dr. Rafik Abadier Medical Malpractice Lawsuits - Court Case # 2005CA 3977

Indemnity Paid: $400,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200743911
Claim Number :A05-32494-03
Date Submitted :1/12/2007
 
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 Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRafik Abadier
Insurer TypeStreet Address of Practice
Licensed308 W Highland Blvd.
CityStateZip CodeCounty
InvernessFL34452Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
28009$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME59443Cardiovascular Disease - No Surgery80422

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
9/13/20035/9/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Treatment was sought for chest pain of unknown etiology.Patient diagnosed with atypical chest pain, ruled out acute myocardial infarction.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Intra-arterial injection of phenergan by nursing staff.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis and treatment of intra-arterial injection of phenergan.
Principal Injury Giving Rise To The Claim
Amputation of right hand.
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
9/26/20052005CA 3977
County Suit Filed inDate of Final Disposition
Citrus12/22/2006
Other Defendants Involved in this Claim
Citrus Cardiology Consultants
Citrus 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
12/22/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$400,000
Loss Adjust Expense Paid to Defense Counsel$23,024
All Other Loss Adjustment Expense Paid$17,631
Injured Person's Total Non-Economic Loss$400,000
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. Walter Choung Medical Malpractice Lawsuits - Court Case # 2011 3097

Indemnity Paid: $375,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201263759
Claim Number :41487-01
Date Submitted :5/2/2012
 
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
IndividualWalter Choung
Insurer TypeStreet Address of Practice
LicensedP.O. Box 640580
CityStateZip CodeCounty
Beverly HillsFL34464Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
44783$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME66779Surgery - Orthopedic80154

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
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
3/10/20083/28/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Gangrene, right foot.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right bunionectomy, metatarsal head resection toes 2-5, hammer toe correction, toes 2 & 3.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Alleged delay in diagnosis and treatment of gangrene, resulting in partial amputation of right foot.
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
9/9/20112011 3097
County Suit Filed inDate of Final Disposition
Citrus4/11/2012
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
4/11/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$375,000
Loss Adjust Expense Paid to Defense Counsel$10,770
All Other Loss Adjustment Expense Paid$5,116
Injured Person's Total Non-Economic Loss$375,000
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. Komala N Bhushan Medical Malpractice Lawsuits - Court Case # 2005-CA-3806

Indemnity Paid: $350,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200848768
Claim Number :20340
Date Submitted :8/12/2008
 
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
IndividualKomalaNBhushan
Insurer TypeStreet Address of Practice
LicensedHighway 491 Suite 512
CityStateZip CodeCounty
LecantoFL34461Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600582 03$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME68580Pediatrics - Minor Surgery49533

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
10/2/20037/8/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Flu symptoms
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :130.3
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly manage patient
Principal Injury Giving Rise To The Claim
Myocarditis
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/6/20052005-CA-3806
County Suit Filed inDate of Final Disposition
Citrus6/12/2008
Other Defendants Involved in this Claim
Fredrick, MD, Bryan D
Citrus Memorial Hospital
Nature Coast Pediatrics
Citrus Emergency 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
2/26/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$350,000
Loss Adjust Expense Paid to Defense Counsel$58,762
All Other Loss Adjustment Expense Paid$25,402
Injured Person's Total Non-Economic Loss$350,000
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
Risk management has counseled insured
 
Updates
 
 
Date of Change:8/12/2008 1:48:50 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 06/12/08
 
Field ChangedFormer ValueNew Value
Date of Final Disposition07-FEB-0812-JUN-08

 

 

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Dr. Alex T Villacastin Medical Malpractice Lawsuits - Court Case # 2010-CA-6043

Indemnity Paid: $325,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264682
Claim Number :32243
Date Submitted :8/29/2012
 
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
IndividualAlexTVillacastin
Insurer TypeStreet Address of Practice
LicensedPO Box 640573
CityStateZip CodeCounty
Beverly HillsFL34464Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1616023 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME71085Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Nursing Home 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
7/31/200811/4/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pneumonia
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 diagnose and treat pneumonia
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
12/21/20102010-CA-6043
County Suit Filed inDate of Final Disposition
Citrus8/28/2012
Other Defendants Involved in this Claim
Suncoast Primary Care Specialists
Villacastin, ARNP, Alexander T
Life Care Center of Citrus County
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
8/28/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$325,000
Loss Adjust Expense Paid to Defense Counsel$59,136
All Other Loss Adjustment Expense Paid$12,066
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$100,000$0
Wage Loss$0$0
Other Expenses$0$150,000
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. Harold C Ward Medical Malpractice Lawsuits - Court Case # 2005-CA-320

Indemnity Paid: $300,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200536945
Claim Number :20771
Date Submitted :10/1/2005
 
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
IndividualHaroldCWard
Insurer TypeStreet Address of Practice
Licensed8490 W Homosassa Trail
CityStateZip CodeCounty
HomosassaFL34448Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600612 02$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
OS4812Ophthalmology - Minor Surgery5575

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
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
1/27/20036/22/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Cataracts
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Cataract surgery
Diagnostic Code :366.8
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to discontinue Plavix prior to surgery
Principal Injury Giving Rise To The Claim
Coronary vessel occlusion
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
2/9/20052005-CA-320
County Suit Filed inDate of Final Disposition
Citrus8/29/2005
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
8/29/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$300,000
Loss Adjust Expense Paid to Defense Counsel$17,224
All Other Loss Adjustment Expense Paid$4,076
Injured Person's Total Non-Economic Loss$200,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$100,000$0
Wage Loss$0$0
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. Oliver K Sevilla Medical Malpractice Lawsuits - Court Case # 2008-CA-1457

Indemnity Paid: $292,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201263510
Claim Number :26509
Date Submitted :6/22/2012
 
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
IndividualOliverKSevilla
Insurer TypeStreet Address of Practice
Licensed5616 w. Norrell Bryant Highway
CityStateZip CodeCounty
Crystal RiverFL34429Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600609 05$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME93238Pulmonary Diseases - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
4/20/200611/12/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pneumonia
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 diagnose and treat pneumonia
Principal Injury Giving Rise To The Claim
Respiratory failure
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/11/20082008-CA-1457
County Suit Filed inDate of Final Disposition
Citrus5/30/2012
Other Defendants Involved in this Claim
Shukla, MD, Manojkumar B
Citrus Pulmonary Consultants
Seven Rivers 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
3/14/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$292,500
Loss Adjust Expense Paid to Defense Counsel$29,867
All Other Loss Adjustment Expense Paid$26,970
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$240,000$0
Wage Loss$0$0
Other Expenses$0$700,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:6/22/2012 4:36:09 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 05/30/12
 
Field ChangedFormer ValueNew Value
Date of Final Disposition14-MAR-1230-MAY-12

 

 

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Dr. Constantine A Toumbis Medical Malpractice Lawsuits - Court Case # 2010-CA-763

Indemnity Paid: $281,250.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201160828
Claim Number :30804-30805
Date Submitted :7/5/2011
 
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
IndividualConstantineAToumbis
Insurer TypeStreet Address of Practice
LicensedPO Box 1990
CityStateZip CodeCounty
Crystal RiverFL34423Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1616017 00$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME80012Surgery - Orthopedic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Special Procedure Room 
Date of OccurrenceDate Reported to Insurer
2/14/20086/18/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Post-op wound infection
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescribed antibiotics
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged improper selection of post-op antibiotics and failure to discontinue Gentamicin
Principal Injury Giving Rise To The Claim
Bilateral vestibulopathy, toxic labyrinthitis, and hypoactive labyrinths.
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
3/5/20102010-CA-763
County Suit Filed inDate of Final Disposition
Citrus6/21/2011
Other Defendants Involved in this Claim
Citrus Orthopaedic & Joint Institute
Amedisys Home Health of Florida
Seven Rivers 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
6/2/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$281,250
Loss Adjust Expense Paid to Defense Counsel$28,999
All Other Loss Adjustment Expense Paid$9,515
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$6,618$0
Wage Loss$0$0
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:7/5/2011 10:17:47 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 06/21/11
 
Field ChangedFormer ValueNew Value
Date of Final Disposition02-JUN-1121-JUN-11

 

 

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Dr. Abel Garibaldi Medical Malpractice Lawsuits - Court Case # 2007 CA 1946

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200953764
Claim Number :HM099213
Date Submitted :5/22/2009
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDeniseNEscribano
Street Address
7886 Woodland Center Blvd
CityStateZip
TampaFL33614
PhoneExtFaxE-Mail Address
(813) 880 - 5137 (312) 894 - 3680denise.escribano@cna.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAbel Garibaldi
Insurer TypeStreet Address of Practice
Licensed580 St. Johnsbuy Rd. Suite D
CityStateZip CodeCounty
LittletonNH03561Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0283540813$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME92303Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
8/28/20051/5/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Empema & Pulmonary Artery Aneurysm
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to treat pulmonary artery aneurysm. (patient was deemed not to be a surgical candidate)
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was no Misdiagnosis made.
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
4/25/20072007 CA 1946
County Suit Filed inDate of Final Disposition
Citrus5/1/2009
Other Defendants Involved in this Claim
Javier, Luis
Citrus Memorial Hospital
Fernandez, Mark
Campbell, Steven
Crouch, Fred
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
5/6/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$18,709
All Other Loss Adjustment Expense Paid$52,514
Injured Person's Total Non-Economic Loss$250,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$43,314$0
Wage Loss$0$260,967
Other Expenses$1,000$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured discussed case with defense counsel and insurance personnel.
 
Updates
 
No updates found.

 

 

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Dr. Alex A Tambrini Medical Malpractice Lawsuits - Court Case # 2008 CA 5706

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200953927
Claim Number :MM249192
Date Submitted :6/15/2009
 
Insurer Information
 
Insurer NameCoverage Type
EVANSTON INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
36-2950161 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCherry ERadin
Street Address
Ten Parkway North
CityStateZip
DeerfieldIL60015
PhoneExtFaxE-Mail Address
(847) 572 - 6085 (847) 572 - 6338radin@markelcorp.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAlexATambrini
Insurer TypeStreet Address of Practice
Licensed7991 S. Suncoast Blvd.
CityStateZip CodeCounty
HomosassaFL34446Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MM814584$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME98069Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
11/11/20075/22/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented tothe insured doctor with complaints of neck pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured doctor's plan was to work up the patient for possible CHF based on CXR at teh emergency room and included a BNP, echocardiogram and EKG as well as to work up the patient for sevcere neck pain with bilateral upper extremity radiculopathy including an MRI pf the cervical spine. Hospitalization was offerred by the insured docotr tothe patient and his family in order to work up a possible cardiac origin for his complaints as well as to initiate pain management for the severe neck pain. The patient and family declined the insured doctor's recommendation for hospitalization. The patient returned to have a BNP done on the following day which turned out to be normal.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
before further workup could be completed the patient returned to the emergency room due to cardiac arrest and was pronounced DOA.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/13/20082008 CA 5706
County Suit Filed inDate of Final Disposition
Citrus5/27/2009
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
5/27/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$12,191
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$5,000
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
None
 
Updates
 
No updates found.

 

 

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

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Dr. Dennis R Daake Medical Malpractice Lawsuits - Court Case # 2005 CA 2496

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537239
Claim Number :40-010905
Date Submitted :10/12/2005
 
Insurer Information
 
Insurer NameCoverage Type
TRUCK INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
95-2575892 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualHeidi Tam
Street Address
4680 Wilshire Blvd., Sixth Floor
CityStateZip
Los AngelesCA90010
PhoneExtFaxE-Mail Address
(323) 930 - 7078  heidi.tam@farmersinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualDennisRDaake
Insurer TypeStreet Address of Practice
Licensed6177 Sun Blvd., Apt # 105
CityStateZip CodeCounty
St. PetersburgFL33715Pinellas
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0117776130000$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME15777Emergency Medicine - Including Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
11/11/20023/12/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient's chest x ray and CT scan were linked more to a pulmonary contusion than pneumonia resulting in improper treatment of pneumonia which led to aspiration pneumonia.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to admit the patient to the hospital and properly treat pneumonia, resulting in the death of the patient several months later.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Diagnosed as pulmonary contusion rather than pneumonia.
Principal Injury Giving Rise To The Claim
Untreated pneumonia progressed to aspiration pneumonia that led to patient's death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/17/20052005 CA 2496
County Suit Filed inDate of Final Disposition
Citrus9/19/2005
Other Defendants Involved in this Claim
Shukla, Manojkumar B
Seven Rivers Community 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
10/11/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$6,229
All Other Loss Adjustment Expense Paid$7,211
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$9,800$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
This is a risk management issue.There are no risk managment services available to the insured.
 
Updates
 
No updates found.

 

 

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Dr. Thomas R Antony Medical Malpractice Lawsuits - Court Case # 2006CA1477

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746445
Claim Number :33418-01
Date Submitted :8/3/2007
 
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
IndividualThomasRAntony
Insurer TypeStreet Address of Practice
Licensed800 Medical Center East
CityStateZip CodeCounty
InvernessFL34452Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
60074$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME86004Surgery - Obstetrics - Gynecology80153

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Labor and Delivery Room 
Date of OccurrenceDate Reported to Insurer
7/2/200411/23/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Term pregnancy complicated by gestational diabetes.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Forcep assisted vaginal delivery of female neonate, complicated by shoulder dystocia.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Erb's palsy secondary to shoulder dystocia in NB female requiring reconstructive surgery.
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
4/7/20062006CA1477
County Suit Filed inDate of Final Disposition
Citrus7/18/2007
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
7/18/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$9,895
All Other Loss Adjustment Expense Paid$10,646
Injured Person's Total Non-Economic Loss$250,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$130,000$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. Gisela Trigo Medical Malpractice Lawsuits - Court Case # 2005CA 4279

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200744140
Claim Number :32591-01
Date Submitted :1/26/2007
 
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 Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGisela Trigo
Insurer TypeStreet Address of Practice
Licensed308 West Highland Boulevard
CityStateZip CodeCounty
InvernessFL34452Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
98262$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60456Cardiovascular Disease - Minor Surgery80281

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
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
8/6/20045/31/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Treatment sought due to complaints of chest pain and abnormal EKG, due to underlying coronary artery disease.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
None.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to perform stress test and render treatment due to alleged failure to diagnose and treat for coronary artery disease.
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
10/18/20052005CA 4279
County Suit Filed inDate of Final Disposition
Citrus1/12/2007
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
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$225,000
Loss Adjust Expense Paid to Defense Counsel$15,689
All Other Loss Adjustment Expense Paid$14,955
Injured Person's Total Non-Economic Loss$225,000
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. Roy Liptrap Medical Malpractice Lawsuits - Court Case # 2006 CA 5109

Indemnity Paid: $212,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200849622
Claim Number :EMC-AO-06-67163
Date Submitted :5/19/2008
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
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
IndividualRoy Liptrap
Insurer TypeStreet Address of Practice
Licensed7728 East Allen Drive
CityStateZip CodeCounty
InvernessFL34450Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-4$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
OtherPHYSICIAN ASSISTANT
License NumberSpecialty Code & ClassificationCertification Number
PA3426  

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
11/16/20044/28/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
CARDIOMYOPATHY
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ALLEGED FAILURE TO PROPERLY READ EKG
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAILURE TO PROPERLY READ EKG
Principal Injury Giving Rise To The Claim
PREMATURE DISCHARGE; DEATH
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/8/20072006 CA 5109
County Suit Filed inDate of Final Disposition
Citrus5/18/2008
Other Defendants Involved in this Claim
CITRUS 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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
1/25/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$212,500
Loss Adjust Expense Paid to Defense Counsel$20,478
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
UNKNOWN
 
Updates
 
No updates found.

 

 

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Dr. BRYAN FREDRICK Medical Malpractice Lawsuits - Court Case # 2006 CA 5109

Indemnity Paid: $212,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200851269
Claim Number :EMC-FL-06-51075
Date Submitted :11/4/2008
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
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
IndividualBRYAN FREDRICK
Insurer TypeStreet Address of Practice
Licensed1389 S. WATERVIEW DRIVE
CityStateZip CodeCounty
INVERNESSFL34450Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-4$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME31083Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
11/16/20044/28/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
CARDIOMYOPATHY
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ALLEGED FAILURE TO PROPERLY READ EKG
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAILURE TO PROPERLY READ EKG
Principal Injury Giving Rise To The Claim
PREMATURE DISCHARGE; DEATH
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/8/20072006 CA 5109
County Suit Filed inDate of Final Disposition
Citrus10/30/2008
Other Defendants Involved in this Claim
CITRUS 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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
1/25/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$212,500
Loss Adjust Expense Paid to Defense Counsel$66,948
All Other Loss Adjustment Expense Paid$12,373
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. Lakshmipathi R Reddi Medical Malpractice Lawsuits - Court Case # 2010-CA-3316

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201161745
Claim Number :33287
Date Submitted :10/24/2011
 
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
IndividualLakshmipathiRReddi
Insurer TypeStreet Address of Practice
Licensed6410 W. Gulf to Lake Highway
CityStateZip CodeCounty
Crystal RiverFL34429Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1616004 01$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME50202Surgery - Gastroenterology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilitySuncoast Endoscopy Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Special Procedure Room 
Date of OccurrenceDate Reported to Insurer
7/27/20093/10/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
GI complaints
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Excisional biopsy of lesions during endoscopy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Colonic perforation
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
6/15/20102010-CA-3316
County Suit Filed inDate of Final Disposition
Citrus10/10/2011
Other Defendants Involved in this Claim
Gastroenterology 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
9/6/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$200,000
Loss Adjust Expense Paid to Defense Counsel$20,050
All Other Loss Adjustment Expense Paid$4,292
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
Risk management has counseled insured
 
Updates
 
 
Date of Change:10/24/2011 2:17:17 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 10/10/11
 
Field ChangedFormer ValueNew Value
Date of Final Disposition06-SEP-1110-OCT-11

 

 

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Dr. Thomas Matysik Medical Malpractice Lawsuits - Court Case # 2011-CA-2383

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201366353
Claim Number :16731-01
Date Submitted :3/8/2013
 
Insurer Information
 
Insurer NameCoverage Type
PODIATRY INSURANCE COMPANY OF AMERICAPrimary
Insurer FEINProfessional License Number
58-1403235 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKaren Kessler
Street Address
3000 Meridian Blvd., Suite 400
CityStateZip
FranklinTN37067
PhoneExtFaxE-Mail Address
(615) 371 - 87762249 kkessler@picagroup.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualThomas Matysik
Insurer TypeStreet Address of Practice
Licensed2246 Hwy. 44W
CityStateZip CodeCounty
InvernessFL34453Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
1PD0009710$250,000$750,000
Profession or BusinessOther Profession or Business
Podiatric Physician 
License NumberSpecialty Code & ClassificationCertification Number
PO1995  

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FCitrus
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
3/19/20093/21/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Ingrown nail, left hallux
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
P&A procedure, medial border of left hallux
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient first presented to insured on 2/20/01 for complaints of hard, thick toenails that are difficult to cut and make it difficult to walk when long. She also had pain in ball of feet for several years which were increasing in severity with aching and throbbing pain which got worse if was on her feet a lot. Patient moved up north, but returned to insured on occasion for exam of feet and occasional procedures due to ingrown toenails. On 3/19/09, patient underwent phenol and alcohol partial matrixectomy of her left hallux. On 3/23/09, patientreturned to insured stating she did not change bandage on toe until 10:00 p.m. Friday night although it should have been changed much sooner.She had ischemic changes due to a partially remaining tourniquet. She was admitted to the hospital for IV antibiotics, wound care consult and podiatry consult, per insured, due to necrosis and cellulitis distal first ray, left hallux.Patient was then transferred to another hospital on April 1, 2009, at her request, for a second opinion and received hyperbaric treatments to salvage her toe.Patient alleges insured was negligent in failing to remove a tourniquet from her left, great toe.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage.Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/20/20112011-CA-2383
County Suit Filed inDate of Final Disposition
Citrus2/12/2013
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
8/7/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$200,000
Loss Adjust Expense Paid to Defense Counsel$28,831
All Other Loss Adjustment Expense Paid$3,361
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$223,800$5,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
None - Specialty code #80993
 
Updates
 
No updates found.

 

 

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

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Dr. MARY L KOLAR Medical Malpractice Lawsuits - Court Case # 2010 CA 2075

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470068
Claim Number :TH-08-LLA-87124
Date Submitted :3/11/2014
 
Insurer Information
 
Insurer NameCoverage Type
Team Health, Inc.Primary
Insurer FEINProfessional License Number
62-1562558 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKathyAStockton
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 2404 (713) 461 - 8130kathy_stockton@westernlitigation.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMARYLKOLAR
Insurer TypeStreet Address of Practice
Self-Insurer5318 SANDRA DRIVE
CityStateZip CodeCounty
SPRING HILLFL34607Hernando
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
6795383$250,000$750,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS4815Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
11/11/20074/30/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
NECK PAIN WITH NUBNESS AND TINGLING RADIATING DOWN THE LEFT SHOULDER AND ARM.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
EXAM. CT SCAN OF NECK.CARDIAC ENZYMES. EKG.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
CERVICAL RADICULOPATHY
Principal Injury Giving Rise To The Claim
DEATH DUE TO ACUTE MYOCARDIAL INFARCTION.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/11/20102010 CA 2075
County Suit Filed inDate of Final Disposition
Citrus3/11/2014
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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
2/13/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$200,000
Loss Adjust Expense Paid to Defense Counsel$145,474
All Other Loss Adjustment Expense Paid$31,167
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. Manojkumar B Shukla Medical Malpractice Lawsuits - Court Case # 2008-CA-1457

Indemnity Paid: $195,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201263511
Claim Number :26510
Date Submitted :4/12/2012
 
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
IndividualManojkumarBShukla
Insurer TypeStreet Address of Practice
Licensed5616 W. Norrell Bryant Highway
CityStateZip CodeCounty
Crystal RiverFL34429Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600609 05$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME40661Pulmonary Diseases - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
4/20/200611/12/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pneumonia
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 diagnose and treat pneumonia
Principal Injury Giving Rise To The Claim
Respiratory failure
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/11/20082008-CA-1457
County Suit Filed inDate of Final Disposition
Citrus3/14/2012
Other Defendants Involved in this Claim
Sevilla, MD, Oliver K
Citrus Pulmonary Consultants
Seven Rivers 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
3/14/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$195,000
Loss Adjust Expense Paid to Defense Counsel$29,867
All Other Loss Adjustment Expense Paid$24,670
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$240,000$0
Wage Loss$0$0
Other Expenses$0$700,000
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. Boris Todorovic Medical Malpractice Lawsuits - Court Case # 2007 CA 5767

Indemnity Paid: $190,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200955812
Claim Number :59138401
Date Submitted :12/21/2009
 
Insurer Information
 
Insurer NameCoverage Type
PHYSICIANS INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
13-4235490 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualWandaGCrawford
Street Address
200 East Gaines Street
CityStateZip
TallahasseeFL32399-0319
PhoneExtFaxE-Mail Address
(850) 413 - 31475118 Wanda.Crawford@fldfs.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualBoris Todorovic
Insurer TypeStreet Address of Practice
Licensed18550 US Highway 441
CityStateZip CodeCounty
Mount DoraFL32757Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
131780$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME88563Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
CITRUS MEMORIAL HOSPITAL100023
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/12/20057/17/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient was admitted thru the emergency room with complaints of back and chest pain.There was an alleged failure to timely diagnose an epidural abcess.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient was sent to xray for a CAT scan.The technician had difficulty placing the patient in the machine due to back pain the technician applied pressure tothe patients chest so that he would lay flat.The patient immediately complained that he had no feeling in his legs.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis of patients actual condition
Principal Injury Giving Rise To The Claim
Paralysis of bowel and bladder and lower extremity weakness
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
1/12/20082007 CA 5767
County Suit Filed inDate of Final Disposition
Citrus9/14/2009
Other Defendants Involved in this Claim
Cintrus Memorial Hospital
Bernhart, William
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
9/21/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$190,000
Loss Adjust Expense Paid to Defense Counsel$100,082
All Other Loss Adjustment Expense Paid$86,420
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
None taken injury dure to codefendant departure.
 
Updates
 
No updates found.

 

 

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Dr. Stanley Kokocki Medical Malpractice Lawsuits - Court Case # 2002-CA-1314

Indemnity Paid: $190,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200538190
Claim Number :00-0302
Date Submitted :11/9/2005
 
Insurer Information
 
Insurer NameCoverage Type
CLARENDON NATIONAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
52-0266645 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKim Cote
Street Address
2000 W. Sam Houston Parkway South
CityStateZip
HoustonTX77042
PhoneExtFaxE-Mail Address
(713) 722 - 16481648(713) 243 - 7311kim_cote@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualStanley Kokocki
Insurer TypeStreet Address of Practice
LicensedPO Box 2786
CityStateZip CodeCounty
InvernessFL34451Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
CMP0008492$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60880Surgery - Vascular 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
1/2/200112/7/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented with a left lung cancerous mass.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged negligence to properly perform a bronschoscpy, mediastinoscopy, left thoracotomy, and left upper lobe lobectomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis
Principal Injury Giving Rise To The Claim
Patient's aorta was cut during mediastinoscopy causing his death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/8/20012002-CA-1314
County Suit Filed inDate of Final Disposition
Citrus8/13/2003
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
After notice of appeal is filed or post judgment relief of action is required for recovery.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Directed verdict for defendant. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
8/28/2003
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$190,000
Loss Adjust Expense Paid to Defense Counsel$91,318
All Other Loss Adjustment Expense Paid$17,311
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. HARIHARASUBRAMAN V IYER Medical Malpractice Lawsuits - Court Case # 2010-CA-3129

Indemnity Paid: $180,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201262922
Claim Number :16783S
Date Submitted :6/26/2012
 
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
IndividualHARIHARASUBRAMANVIYER
Insurer TypeStreet Address of Practice
Licensed3475 S. Suncoast Blvd.
CityStateZip CodeCounty
HomosassaFL34448Citrus
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600602 05$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME44371Surgery - General 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MCitrus
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SEVEN RIVERS COMMUNITY HOSPITAL100249
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
1/3/20081/9/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Cholelithiasis
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
Common bile duct injury
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
6/17/20102010-CA-3129
County Suit Filed inDate of Final Disposition
Citrus3/26/2012
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
2/16/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$180,000
Loss Adjust Expense Paid to Defense Counsel$22,712
All Other Loss Adjustment Expense Paid$9,716
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$196,000$0
Wage Loss$7,000$0
Other Expenses$25,000$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:6/26/2012 12:15:12 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 03/26/12
 
Field ChangedFormer ValueNew Value
Date of Final Disposition16-FEB-1226-MAR-12

 

 

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