Medical Malpractice Cases

Medical Malpractice Cases In Dixie County Florida

Dr. HUMBERTO A REVOLLO Medical Malpractice Lawsuits - Court Case # 16-2007-CA-006735

Indemnity Paid: $187,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201056115
Claim Number :1000915-01
Date Submitted :9/17/2010
 
Insurer Information
 
Insurer NameCoverage Type
FLORIDA MEDICAL MALPRACTICE JUAPrimary
Insurer FEINProfessional License Number
59-1625412 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualSUSAN SPIELMAN
Street Address
5814 Reed Street
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0340 (260) 486 - 0782SUSAN.SPIELMAN@MEDPRO.COM
 
Insured Information
 
TypeFirst NameMILast Name
IndividualHUMBERTOAREVOLLO
Insurer TypeStreet Address of Practice
Licensed110 Emerald Lake Drive
CityStateZip CodeCounty
Palm CoastFL32137Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
FL003520$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME30396Radiology - Diagnostic - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MFlagler
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
2/4/20033/14/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest pain and congestion
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Chest X-rays
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose lung cancer and refer for treatment
Principal Injury Giving Rise To The Claim
Death on 3/15/2005
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
11/16/200716-2007-CA-006735
County Suit Filed inDate of Final Disposition
Dixie1/19/2010
Other Defendants Involved in this Claim
Industrial Medicine Group
Depadua & Depadua MD PA d/b/a Industrial Medicine Group
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
1/15/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$187,500
Loss Adjust Expense Paid to Defense Counsel$34,737
All Other Loss Adjustment Expense Paid$14,215
Injured Person's Total Non-Economic Loss$100,000
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
N/A
 
Updates
 
 
Date of Change:9/17/2010 4:13:37 PM
Reason for Change:ALE Update
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel2937434737
All Other Loss Adjustment Expense Paid1247014215

 

 

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