Medical Malpractice Cases

Medical Malpractice Cases In Duval County Florida

Dr. Jenny M Whitworth Medical Malpractice Lawsuits - Court Case # 2017-CA-002742

Indemnity Paid: $85,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201884982
Claim Number : 51502
Date Submitted : 5/21/2018
 
Insurer Information
 
Insurer Name Coverage Type
MAG MUTUAL INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
58-1449198  
Insurer Contact Information
Type Entity Name
Entity MAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
City State Zip
Orlando FL 32819
Phone Ext Fax E-Mail Address
(407) 370 - 3813   (404) 842 - 3319 ctschanz@magmutual.com
 
Insured Information
 
Type First Name MI Last Name
Individual Jenny M Whitworth
Insurer Type Street Address of Practice
Licensed 841 Prudential Dr.
City State Zip Code County
Jacksonville FL 32207 Duval
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1603120 01 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME116355 Surgery - Gynecology  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Duval
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
BAPTIST MEDICAL CENTER SOUTH 23960052
Location of Institutional Injury Other Location of Institutional Injury
Operating Suite  
Date of Occurrence Date Reported to Insurer
9/5/2014 11/19/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Increasing menorrhagia and uterine fibroids
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
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Perforated duodenal ulcer with peritonitis
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
4/27/2017 2017-CA-002742
County Suit Filed in Date of Final Disposition
Duval 4/20/2018
Other Defendants Involved in this Claim
Baptist Medical Center
Baptist SE Gynecological Oncology Assoc.
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/3/2018
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $85,000,000
Loss Adjust Expense Paid to Defense Counsel $31,600
All Other Loss Adjustment Expense Paid $7,332
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $588,484 $0
Wage Loss $0 $400,000
Other Expenses $0 $200,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change: 5/21/2018 3:58:10 PM
Reason for Change: Report updated to reflect Court Document final disposition date of 04/20/18
 
Field Changed Former Value New Value
Date of Final Disposition 03-APR-18 20-APR-18

 

 

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Dr. Loren Z Clayman Medical Malpractice Lawsuits - Court Case # 2015-CA-006436

Indemnity Paid: $8,927,189.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885355
Claim Number : 123456A
Date Submitted : 5/21/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Loren Z Clayman
Insurer Type Street Address of Practice
Licensed 2 Shircliff Way Suite 200
City State Zip Code County
Jacksonville FL 32204 Duval
Policy Number Per Claim Policy Limits Aggregate Policy Limits
123456A $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME23089 Surgery - Plastic  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Duval
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Location Office Surgical Practice
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Office Surgical Practice
Date of Occurrence Date Reported to Insurer
10/24/2014 5/27/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Elective breast enhancements via placement of saline breast implants.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patients involved in this global settlement underwent at least one elective breast enhancement procedure with placement of saline implants.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Not applicable - elective cosmetic procedures.
Principal Injury Giving Rise To The Claim
After passage of time from their last elective procedure, global plaintiff's alleged concerns with their cosmetic results including concerns over repeat saline implant deflation; a known complication with the use of saline implants.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
10/8/2015 2015-CA-006436
County Suit Filed in Date of Final Disposition
Duval 3/27/2018
Other Defendants Involved in this Claim
Clayman, MD, Mark A
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $8,927,189
Loss Adjust Expense Paid to Defense Counsel $285,152
All Other Loss Adjustment Expense Paid $233,842
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Several of the claim were reviewed by medial experts who opined that the rendered care by the insured was in accordance with the standard of care and insurance company staff consulted with insured to discuss preventative measures. Patient safety referral is made if applicable.
 
Updates
 
No updates found.

 

 

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Dr. CLIFFORD C ARN Medical Malpractice Lawsuits - Court Case # 2004-CA-002145

Indemnity Paid: $5,550,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200641929
Claim Number :122592
Date Submitted :4/4/2008
 
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
IndividualCLIFFORDCARN
Insurer TypeStreet Address of Practice
Licensed5500 Blanding Blvd., Suite 1
CityStateZip CodeCounty
JacksonvilleFL32244Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP35921$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME55583Family Physicians or General Practitioners - No Surgery00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
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
2/21/20035/6/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Leukopenia with fever, malaise, sore throat and cough.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Symptomatic care and cough medicine for flu type symptoms.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose pneumococcal pneumonia.
Principal Injury Giving Rise To The Claim
Patient who was diagnosed with pneumococcal pneumonia developed septic shock and died.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/19/20042004-CA-002145
County Suit Filed inDate of Final Disposition
Duval4/10/2006
Other Defendants Involved in this Claim
Arn & Aston, P.A.
Stage of Legal System at which Settlement was Reached or Award Made
During appeal.
Final Method of Claim Disposition
Disposed of by Court
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/13/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$5,550,000
Loss Adjust Expense Paid to Defense Counsel$162,756
All Other Loss Adjustment Expense Paid$135,229
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 has dicussed case with insurance company personnel, medical experts and defense counsel.
 
Updates
 
 
Date of Change:1/5/2007 4:13:59 PM
Reason for Change:Settlement check was cut on 12/13/06.Also updating expense information.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid82033216496
Indemnity Paid04850000
Settlement Reached01
Amount of Loss Adjustment Expense Paid to Defense Counsel126882160899
 
Date of Change:3/15/2007 11:46:21 AM
Reason for Change:Update to reflect change in status and expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid216496221136
Indemnity Paid48500005550000
Legal System StageAfter court verdict and prior to filing of notice of appeal.During appeal.
Amount of Loss Adjustment Expense Paid to Defense Counsel160899161281
 
Date of Change:5/24/2007 4:01:55 PM
Reason for Change:Update to reflect additional legal fees and expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid221136221529
Amount of Loss Adjustment Expense Paid to Defense Counsel161281162704
 
Date of Change:9/6/2007 12:00:42 PM
Reason for Change:Update to reflect reimburse of expenses by reinsurers.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid221529135229
 
Date of Change:4/4/2008 11:15:23 AM
Reason for Change:Report updated to reflect additional legal fees paid.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel162704162756

 

 

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Dr. Randell Powell Medical Malpractice Lawsuits - Court Case # 2001-007974-CA

Indemnity Paid: $4,500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200955170
Claim Number :24485-01
Date Submitted :10/19/2009
 
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
IndividualRandell Powell
Insurer TypeStreet Address of Practice
Licensed836 Prudential Dr, Ste 1105
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
98307$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME50450Surgery - Neurology - Including Child80152

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
BAPTIST MEDICAL CENTER AND WOLFSON 100088
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/26/19998/8/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Hydrocephalus.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Endoscopic third ventriculostomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Severe brain 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
12/7/20012001-007974-CA
County Suit Filed inDate of Final Disposition
Duval9/28/2009
Other Defendants Involved in this Claim
Baptist 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
9/28/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$4,500,000
Loss Adjust Expense Paid to Defense Counsel$276,594
All Other Loss Adjustment Expense Paid$192,325
Injured Person's Total Non-Economic Loss$4,500,000
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. Mark A Clayman Medical Malpractice Lawsuits - Court Case # 2015-CA-006436

Indemnity Paid: $3,072,811.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885354
Claim Number : 123456
Date Submitted : 5/21/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Mark A Clayman
Insurer Type Street Address of Practice
Licensed 2 Shircliff Way Suite 200
City State Zip Code County
Jacksonville FL 32204 Duval
Policy Number Per Claim Policy Limits Aggregate Policy Limits
123456 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME92516 Surgery - Plastic  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Duval
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Location Office Surgical Practice
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Office Surgical Practice
Date of Occurrence Date Reported to Insurer
10/24/2014 5/27/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Elective breast enhancements via placement of saline breast implants.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patients involved in this global settlement underwent as least one elective breast enhancement procedure with placement of saline implants.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Not applicable - elective cosmetic procedures.
Principal Injury Giving Rise To The Claim
After passage of time from their last elective procedure, global plaintiff's alleged concerns with their cosmetic results including concerns over repeat saline implant deflation; a known complication with the sue of saline implants.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
10/8/2015 2015-CA-006436
County Suit Filed in Date of Final Disposition
Duval 3/27/2018
Other Defendants Involved in this Claim
Clayman, MD, Loren Z
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $3,072,811
Loss Adjust Expense Paid to Defense Counsel $95,050
All Other Loss Adjustment Expense Paid $77,947
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Several of the claim were reviewed by medial experts who opined that the rendered care by the insured was in accordance with the standard of care and insurance company staff consulted with insured to discuss preventative measures. Patient safety referral is made if applicable.
 
Updates
 
No updates found.

 

 

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Dr. Shailesh K Gupta Medical Malpractice Lawsuits - Court Case # 2008-CA-015622-MA

Indemnity Paid: $3,013,857.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201056247
Claim Number :06J28658PL-H
Date Submitted :2/1/2010
 
Insurer Information
 
Insurer NameCoverage Type
Univ of FL JHMHC/Jacksonville Self Insurance ProgExcess
Insurer FEINProfessional License Number
59730209 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDanelleHTowater
Street Address
3450 Hull Road, Ste 4358
CityStateZip
GainesvilleFL32611-2735
PhoneExtFaxE-Mail Address
(352) 273 - 7006 (352) 273 - 7287towatdt@shands.ufl.edu
 
Insured Information
 
TypeFirst NameMILast Name
IndividualShaileshKGupta
Insurer TypeStreet Address of Practice
Self-Insurer655 W 8th Street
CityStateZip CodeCounty
JacksonvilleFL32209Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
UFBOT06J-H$5,000,000*NR
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME81086Surgery - Opthalmology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
UNIVERSITY MEDICAL CENTER (DUVAL)100001
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
10/21/20067/8/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Retinopathy of Prematurity
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Screening premature infant for Retinopathy of Prematurity
Diagnostic Code :360.26
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Bilateral Blindness
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
12/9/20082008-CA-015622-MA
County Suit Filed inDate of Final Disposition
Duval4/29/2009
Other Defendants Involved in this Claim
Grover, Sandeep
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
4/29/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$3,013,857
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
Assessment of treatment with physician
 
Updates
 
No updates found.

 

 

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

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Dr. Kasra A Nabizadeh Medical Malpractice Lawsuits - Court Case # 16-2012-CA-001205

Indemnity Paid: $2,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201367039
Claim Number :41731/42481
Date Submitted :6/12/2013
 
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
IndividualKasraANabizadeh
Insurer TypeStreet Address of Practice
Licensed11512 Lake Mead Ave., Suite 513
CityStateZip CodeCounty
JacksonvilleFL32258Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600820 09$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME51611Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL JACKSONVILLE100179
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
8/5/20106/26/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Heparin-induced thrombocytopenia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescribed heparin
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis and treatment of heparin-induced thrombocytopenia
Principal Injury Giving Rise To The Claim
Bilateral lower extremity amputations
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
10/29/201216-2012-CA-001205
County Suit Filed inDate of Final Disposition
Duval5/23/2013
Other Defendants Involved in this Claim
Jacksonville Critical Care
Southeast Emergency Consultants
Bohri Orthopaedic & Sports Medicine
Bohsali, MD, Kamal I
Jenkins, MD, Frederick L
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
5/3/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$2,000,000
Loss Adjust Expense Paid to Defense Counsel$24,768
All Other Loss Adjustment Expense Paid$13,722
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$211,497$0
Wage Loss$0$294,755
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:6/12/2013 12:41:42 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 05/23/13
 
Field ChangedFormer ValueNew Value
Date of Final Disposition03-MAY-1323-MAY-13

 

 

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Dr. Safeer A Ashraf Medical Malpractice Lawsuits - Court Case # 2012-CA-002677

Indemnity Paid: $2,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201780852
Claim Number : 41067/39113
Date Submitted : 1/14/2017
 
Insurer Information
 
Insurer Name Coverage Type
MAG MUTUAL INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
58-1449198  
Insurer Contact Information
Type Entity Name
Entity MAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
City State Zip
Orlando FL 32819
Phone Ext Fax E-Mail Address
(407) 370 - 3813   (407) 370 - 2247 ctschanz@magmutual.coom
 
Insured Information
 
Type First Name MI Last Name
Individual Safeer A Ashraf
Insurer Type Street Address of Practice
Licensed 9143 Phillips Hwy. Ste. 560
City State Zip Code County
Jacksonville FL 32256 Duval
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1600451 10 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME103831 Hematology - Minor Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Duval
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
BAPTIST HOSPITAL 100093
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
2/12/2010 10/19/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Carotid artery clot
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 clot in left internal carotid artery
Principal Injury Giving Rise To The Claim
Brain injury
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
4/25/2012 2012-CA-002677
County Suit Filed in Date of Final Disposition
Duval 12/19/2016
Other Defendants Involved in this Claim
Sengstock, MD, Charles
Pennington, MD, John
Naot, MD, Yuval Z
Rosemund, MD, R E
Namen, MD, Andrew M
Baptist Medical Center-South
Fernandez, MD, Kristin
Beabeau, MD, Eugene
ICON
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/19/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $2,000,000
Loss Adjust Expense Paid to Defense Counsel $127,582
All Other Loss Adjustment Expense Paid $53,525
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $801,678 $9,000,000
Wage Loss $0 $1,000,000
Other Expenses $0 $1,000,000
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. Duke G Pao Medical Malpractice Lawsuits - Court Case # 16-2015-CA-003619

Indemnity Paid: $2,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201783186
Claim Number : 54039
Date Submitted : 9/22/2017
 
Insurer Information
 
Insurer Name Coverage Type
MAG MUTUAL INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
58-1449198  
Insurer Contact Information
Type Entity Name
Entity MAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
City State Zip
Orlando FL 32819
Phone Ext Fax E-Mail Address
(407) 370 - 3813   (407) 370 - 2247 ctschanz@magmutual.com
 
Insured Information
 
Type First Name MI Last Name
Individual Duke G Pao
Insurer Type Street Address of Practice
Licensed 7758 Burnt Oak Trail
City State Zip Code County
Jacksonville FL 32256 Duval
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1600004 18 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME82560 Radiology - interventional  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Duval
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Outpatient Facility  
Name of Institution Code
MEMORIAL HOSPITAL JACKSONVILLE 100179
Location of Institutional Injury Other Location of Institutional Injury
Special Procedure Room  
Date of Occurrence Date Reported to Insurer
10/9/2013 7/21/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Renal cell carcinoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Microwave ablation
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Urinary system injury
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
10/22/2015 16-2015-CA-003619
County Suit Filed in Date of Final Disposition
Duval 9/8/2017
Other Defendants Involved in this Claim
Drs. Mori Bean & Brooks
Memorial Hospital
Neuwave Med. Inc.
Crouse, Marlina
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/8/2017
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $2,000,000
Loss Adjust Expense Paid to Defense Counsel $97,267
All Other Loss Adjustment Expense Paid $35,872
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $479,960
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. NAM PHUONG T LU Medical Malpractice Lawsuits - Court Case # 2006-CA-003552

Indemnity Paid: $1,900,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200952973
Claim Number :23787
Date Submitted :3/18/2009
 
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
IndividualNAM PHUONGTLU
Insurer TypeStreet Address of Practice
Licensed11512 Lake Mead Ave. #513
CityStateZip CodeCounty
JacksonvilleFL32256Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600820 03$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
OS8549Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SAINT LUKES' HOSPITAL100151
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
10/20/200312/27/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Aseptic meningitis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Brain stem herniation following LP
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to order appropriate administration and monitoring of Dilaudid
Principal Injury Giving Rise To The Claim
Progressive respiratory failure
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/12/20062006-CA-003552
County Suit Filed inDate of Final Disposition
Duval2/23/2009
Other Defendants Involved in this Claim
Martinez-Bejar, MD, Lucia M
Stage of Legal System at which Settlement was Reached or Award Made
During trial, but before court verdict.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Directed verdict for plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
2/5/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,900,000
Loss Adjust Expense Paid to Defense Counsel$183,117
All Other Loss Adjustment Expense Paid$183,999
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
 
No updates found.

 

 

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Dr. Saumil R Oza Medical Malpractice Lawsuits - Court Case # 16-2010-CA-000133

Indemnity Paid: $1,750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201265017
Claim Number :32929/32931
Date Submitted :10/8/2012
 
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
IndividualSaumilROza
Insurer TypeStreet Address of Practice
Licensed820 Prudential Drive
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600328 11$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME102318Surgery - Cardiovascular Disease 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
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
2/6/20091/22/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Persistent a-fib
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 place patient on anticoagulation therapy following pacemaker placement
Principal Injury Giving Rise To The Claim
Acute stroke
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
6/1/201016-2010-CA-000133
County Suit Filed inDate of Final Disposition
Duval12/22/2010
Other Defendants Involved in this Claim
Diagnostic Cardiology Assoc.
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
12/22/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,750,000
Loss Adjust Expense Paid to Defense Counsel$14,284
All Other Loss Adjustment Expense Paid$4,113
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$500,000$1,500,000
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. Shailesh K Gupta Medical Malpractice Lawsuits - Court Case # 2008-CA-015622-MA

Indemnity Paid: $1,498,614.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201056245
Claim Number :06J28658PL(A)
Date Submitted :2/1/2010
 
Insurer Information
 
Insurer NameCoverage Type
Univ of FL JHMHC/Jacksonville Self Insurance ProgPrimary
Insurer FEINProfessional License Number
59730209 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDanelleHTowater
Street Address
3450 Hull Road, Ste 4358
CityStateZip
GainesvilleFL32611-2735
PhoneExtFaxE-Mail Address
(352) 273 - 7006 (352) 273 - 7287towatdt@shands.ufl.edu
 
Insured Information
 
TypeFirst NameMILast Name
IndividualShaileshKGupta
Insurer TypeStreet Address of Practice
Self-Insurer655 W 8th Street
CityStateZip CodeCounty
JacksonvilleFL32209Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
UFBOT06J$2,000,000*NR
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME81086Surgery - Opthalmology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
UNIVERSITY MEDICAL CENTER (DUVAL)100001
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
10/21/20067/8/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Retinopathy of Prematurity
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Screening premature infant for Retinopathy of Prematurity
Diagnostic Code :360.26
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Bilateral Blindness
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
12/9/20082008-CA-015622-MA
County Suit Filed inDate of Final Disposition
Duval4/29/2009
Other Defendants Involved in this Claim
Grover, Sandeep
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
4/29/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,498,614
Loss Adjust Expense Paid to Defense Counsel$0
All Other Loss Adjustment Expense Paid$34,451
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
Assessment of treatment with physician
 
Updates
 
No updates found.

 

 

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

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Dr. Brent L Beadling Medical Malpractice Lawsuits - Court Case # 16-2009-CA-013592

Indemnity Paid: $1,250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201057493
Claim Number :17350S/30528
Date Submitted :6/2/2010
 
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
IndividualBrentLBeadling
Insurer TypeStreet Address of Practice
Licensed1325 San Marco Blvd.
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600517 06$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME69283Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
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
8/16/20075/13/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Leukemia
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 manage acute leukemia
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
11/17/200916-2009-CA-013592
County Suit Filed inDate of Final Disposition
Duval5/27/2010
Other Defendants Involved in this Claim
Baptist 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
5/27/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,250,000
Loss Adjust Expense Paid to Defense Counsel$26,020
All Other Loss Adjustment Expense Paid$7,825
Injured Person's Total Non-Economic Loss$0
Deductible$250,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$25,000$0
Wage Loss$0$1,000,000
Other Expenses$15,000$500,000
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. Sabine R O'Laughlin Medical Malpractice Lawsuits - Court Case # 2007-CA-002671

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200951984
Claim Number :24677
Date Submitted :1/7/2009
 
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
IndividualSabineRO'Laughlin
Insurer TypeStreet Address of Practice
Licensed800 Prudential Drive
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600794 04$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60593Pathology - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
BAPTIST MEDICAL CENTER - BEACHES100117
Location of Institutional InjuryOther Location of Institutional Injury
OtherPathology Department
Date of OccurrenceDate Reported to Insurer
1/21/200311/7/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Invasive nasopharyngeal carcinoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Biopsy of neck mass
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to correctly interpret biopsy slide as nasopharyngeal carcinoma rather than Hodgkin's disease
Principal Injury Giving Rise To The Claim
Progression of cancer leading to death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/5/20072007-CA-002671
County Suit Filed inDate of Final Disposition
Duval12/12/2008
Other Defendants Involved in this Claim
Baptist Medical Center
McKinney, MD, Barbara
Ioannides, MD, Kyriakos
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
12/5/2008
 
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$34,458
All Other Loss Adjustment Expense Paid$13,482
Injured Person's Total Non-Economic Loss$1,000,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$250,000$0
Wage Loss$140,000$800,000
Other Expenses$5,385$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. Carey W Goodman Medical Malpractice Lawsuits - Court Case # 3:06-cv-692

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200849728
Claim Number :VHS-CONT-74274
Date Submitted :5/29/2008
 
Insurer Information
 
Insurer NameCoverage Type
EVEREST INDEMNITY INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
22-3520347 
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
IndividualCareyWGoodman
Insurer TypeStreet Address of Practice
Licensed80 Victoria Place
CityStateZip CodeCounty
OxfordAL36203Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
4700000062-041$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME81345Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Prison 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
2/22/20056/7/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Inmate with history of epilepsy
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to administer proper medications for epilepsy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Medication related
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
8/2/20063:06-cv-692
County Suit Filed inDate of Final Disposition
Duval5/28/2008
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
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
5/8/2008
 
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$75,157
All Other Loss Adjustment Expense Paid$941
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. Steven S Nauman Medical Malpractice Lawsuits - Court Case # 16-2007-CA-001870

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200849879
Claim Number :23936
Date Submitted :6/17/2008
 
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
IndividualStevenSNauman
Insurer TypeStreet Address of Practice
Licensed820 Prudential Dr., Ste. 615
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600328 08$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME42210Cardiovascular Disease - No Surgery5101

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
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
2/28/20055/30/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Atrial fibrillation
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :459.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to discontinue Coumadin
Principal Injury Giving Rise To The Claim
Fatal cerebral bleed
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/2/200716-2007-CA-001870
County Suit Filed inDate of Final Disposition
Duval5/30/2008
Other Defendants Involved in this Claim
Southern Heart 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
5/22/2008
 
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$65,155
All Other Loss Adjustment Expense Paid$25,679
Injured Person's Total Non-Economic Loss$1,000,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$30,890$0
Wage Loss$0$6,300,000
Other Expenses$32,629$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. Wylene Bhanji Medical Malpractice Lawsuits - Court Case # 2005 CA 003662

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643166
Claim Number :EMC-AO-05-37002
Date Submitted :11/16/2006
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
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
IndividualWylene Bhanji
Insurer TypeStreet Address of Practice
Licensed1421 S BURGANDY TRL
CityStateZip CodeCounty
JACKSONVILLEFL32259-5444Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-3$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS9034Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SAINT LUKES' HOSPITAL100151
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/12/20042/21/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Hypoxic ischemic brain injury
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient to ED after slip and fall in bathroom, landing on right arm.Dr. Bhanji administered Dilaudid and Valium before placing splint.She was also given Phenergan, Colase, Valium as muscle relaxer, along with Oxycontin and Dilaudid.Patient found at home unresponsive and EMS summoned.Returned to hospital
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Medication related
Principal Injury Giving Rise To The Claim
Alleged excessive medication and alleged failure to admit
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
5/31/20052005 CA 003662
County Suit Filed inDate of Final Disposition
Duval11/15/2006
Other Defendants Involved in this Claim
St. Luke's Hospital
Florida EM-1 Medical 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
3/31/2006
 
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$30,129
All Other Loss Adjustment Expense Paid$6,690
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. GEORGE E CHISHOLM Medical Malpractice Lawsuits - Court Case # 162004CA000538

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200744088
Claim Number :502275
Date Submitted :1/25/2007
 
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
IndividualGEORGEECHISHOLM
Insurer TypeStreet Address of Practice
Licensed1400 Prudential Drive, Ste. 5
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
52422$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60786Surgery - General 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SAINT VINCENT'S MEDICAL CENTER100040
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
5/17/20026/24/2002
 
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
Failure to recognize an intraoperative complication
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
4/20/2004162004CA000538
County Suit Filed inDate of Final Disposition
Duval1/2/2007
Other Defendants Involved in this Claim
North Florida Surgeons, P.A.
Sparks, MD , DouglasH
Johnston, MD , DavidP
St. Vincent's 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
1/2/2007
 
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$26,086
All Other Loss Adjustment Expense Paid$14,015
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
 
No updates found.

 

 

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Dr. DANIELLE R REZNICSEK Medical Malpractice Lawsuits - Court Case # 2007-CA-005393

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200848367
Claim Number :25012/25013
Date Submitted :1/28/2008
 
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
IndividualDANIELLERREZNICSEK
Insurer TypeStreet Address of Practice
Licensed425 N. Lee St., Suite 202-A
CityStateZip CodeCounty
JacksonvilleFL32204Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PRF 1404910 00$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85463Internal Medicine - No Surgery3841

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SAINT VINCENT'S MEDICAL CENTER100040
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
10/31/20051/25/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Incomplete quadriplegia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :722.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to order appropriate diagnostic study and identify neurosurgical emergency
Principal Injury Giving Rise To The Claim
C6-7 quadriplegia
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
6/27/20072007-CA-005393
County Suit Filed inDate of Final Disposition
Duval1/8/2008
Other Defendants Involved in this Claim
Davenport, MD, John D
Fulton, MD, Robert B
N. Florida Hospitalists
St. Vincent's Medical Center
Shands-Jacksonville
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
1/15/2008
 
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$8,983
All Other Loss Adjustment Expense Paid$1,766
Injured Person's Total Non-Economic Loss$1,000,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$1,800,000$10,000,000
Wage Loss$0$1,000,000
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. Marc H Bivins Medical Malpractice Lawsuits - Court Case # 16-2004-CA-003154

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200536330
Claim Number :19187
Date Submitted :8/11/2005
 
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
IndividualMarcHBivins
Insurer TypeStreet Address of Practice
Licensed1650-302 Margaret Street #304
CityStateZip CodeCounty
JacksonvilleFL32204Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600413 02$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME52294Internal Medicine - Minor Surgery1102

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SAINT VINCENT'S MEDICAL CENTER100040
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/29/200212/29/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Acute myocardial infarction
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
EKG
Diagnostic Code :425.8
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to recognize and respond to signs and symptoms of acute myocardial event.
Principal Injury Giving Rise To The Claim
Severe ischemic cardiomyopathy
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
5/29/200416-2004-CA-003154
County Suit Filed inDate of Final Disposition
Duval8/9/2005
Other Defendants Involved in this Claim
Williams, M.D., Marcus R
St. Vincents 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
8/9/2005
 
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$30,899
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$374,992$5,700,000
Wage Loss$51,244$1,121,434
Other Expenses$0$750,000
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. JULIE A BUCKLEY Medical Malpractice Lawsuits - Court Case # 99-6476-CA

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537246
Claim Number :DM07200306-09J005
Date Submitted :10/12/2005
 
Insurer Information
 
Insurer NameCoverage Type
THE TRAVELERS CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
41-1435765 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualPatriciaWThomas
Street Address
3097 Satellite Blvd, Bldg. 700
CityStateZip
DuluthGA30096
PhoneExtFaxE-Mail Address
(770) 497 - 5365 (770) 263 - 4675pthomas@stpaultravelers.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJULIEABUCKLEY
Insurer TypeStreet Address of Practice
Licensed1200 Gulf Life Drive, Apt 701
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
DM07200306$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME65677Pediatrics - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
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
9/23/19977/7/1999
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pneumoccal meningitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No procedure performed.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose pneumoccal meningitus.
Principal Injury Giving Rise To The Claim
Neurological impairment
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
8/7/199999-6476-CA
County Suit Filed inDate of Final Disposition
Duval9/12/2005
Other Defendants Involved in this Claim
Prudential Health 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
9/12/2005
 
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$134,544
All Other Loss Adjustment Expense Paid$41,023
Injured Person's Total Non-Economic Loss$322,000
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
Not Applicable
 
Updates
 
No updates found.

 

 

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Dr. Bradford W Joseph Medical Malpractice Lawsuits - Court Case # 16-2011-CA-002492

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264263
Claim Number :35742
Date Submitted :7/9/2012
 
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
IndividualBradfordWJoseph
Insurer TypeStreet Address of Practice
Licensed4800 Belfort Road, Suite 300
CityStateZip CodeCounty
JacksonvilleFL32256Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600542 08$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME53034Surgery - Gastroenterology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
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
11/9/200911/11/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Acute gastric problems
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescribed Reglan
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to monitor for complications of prolonged Reglan use
Principal Injury Giving Rise To The Claim
Tardive Dyskinesia
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
9/21/201116-2011-CA-002492
County Suit Filed inDate of Final Disposition
Duval7/5/2012
Other Defendants Involved in this Claim
Wyeth, LLC
Schwarz Pharma Inc.
UCB, Inc.
Alaven Pharmaceutical LLC
Pliva, Inc.
Teva Pharmaceutical, Inc.
Qualitest Pharmaceuticals, 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
7/5/2012
 
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$25,334
All Other Loss Adjustment Expense Paid$6,946
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$1,000,000
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. Lawrence S Goldberg Medical Malpractice Lawsuits - Court Case # 16-2011-CA-001554

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264113
Claim Number :35003
Date Submitted :7/19/2012
 
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
IndividualLawrenceSGoldberg
Insurer TypeStreet Address of Practice
Licensed4800 Belfort Road
CityStateZip CodeCounty
JacksonvilleFL32256Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600542 08$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME32734Surgery - Gastroenterology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
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
2/26/20098/24/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
GERD
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescribed Reglan
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged improper prescribing of Reglan
Principal Injury Giving Rise To The Claim
Tardive Dyskinesia
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
2/18/201116-2011-CA-001554
County Suit Filed inDate of Final Disposition
Duval7/3/2012
Other Defendants Involved in this Claim
Baptist Primary Care
Calhoun, MD, Patricia M
Teva Pharmaceuticals USA, Inc.
Purepac Pharmaceuticals
Borland Groover Clinic, PA
Walgreen Company
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
6/4/2012
 
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$57,046
All Other Loss Adjustment Expense Paid$15,679
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$15,000$500,000
Wage Loss$0$0
Other Expenses$0$100,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:7/19/2012 12:49:24 PM
Reason for Change:Report udpated to reflect Court Document final disposition date of 07/03/12
 
Field ChangedFormer ValueNew Value
Date of Final Disposition04-JUN-1203-JUL-12

 

 

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Dr. VIRGILIO G DE PADUA Medical Malpractice Lawsuits - Court Case # 16-2009-CA-016846

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201162277
Claim Number :30756
Date Submitted :2/20/2012
 
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
IndividualVIRGILIOGDE PADUA
Insurer TypeStreet Address of Practice
Licensed1325 San Marco Blvd., Suite 903
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600517 07$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME61040Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
BAPTIST MEDICAL CENTER - BEACHES100117
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
4/17/20086/16/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Epidural abscess
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 epidural abscess
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
11/2/200916-2009-CA-016846
County Suit Filed inDate of Final Disposition
Duval1/9/2012
Other Defendants Involved in this Claim
Baptist Medical Center
Andrew, MD, Rebecca
Shah, MD, Hardik
Chetan, MD, Sashi
Baptist Primary Care
Collier, MD, Frank R
Collier Spine & Pain Institute
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
11/10/2011
 
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$38,700
All Other Loss Adjustment Expense Paid$19,462
Injured Person's Total Non-Economic Loss$0
Deductible$250,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$1,000,000$3,800,000
Wage Loss$150,000$0
Other Expenses$0$500,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:2/20/2012 12:15:52 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 01/09/2012
 
Field ChangedFormer ValueNew Value
Date of Final Disposition10-NOV-1109-JAN-12

 

 

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Dr. TRAVIS W MCCOY Medical Malpractice Lawsuits - Court Case # 2014-CA-000735

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201471385
Claim Number :308731
Date Submitted :7/22/2014
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
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
IndividualTRAVISWMCCOY
Insurer TypeStreet Address of Practice
Licensed836 Prudential Drive, Suite 902
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
939336$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME106665Surgery - Obstetrics - Gynecology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SAINT VINCENT'S MEDICAL CENTER100040
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/20/20137/23/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Removal of Fibroids.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Myomectomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient sustained post-operative bleed, resulting in death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/29/20142014-CA-000735
County Suit Filed inDate of Final Disposition
Duval7/14/2014
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 not subject to Arbitration.
Date of Payment
7/9/2014
 
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$14,615
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
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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