Medical Malpractice Cases

Medical Malpractice Cases In Flagler County Florida

Dr. Glenn D Zimmet Medical Malpractice Lawsuits - Court Case # 2009 Ca 001658

Indemnity Paid: $850,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201057731
Claim Number :SHI-09-85516
Date Submitted :6/28/2010
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancyJThomas
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGlennDZimmet
Insurer TypeStreet Address of Practice
Licensed1340 Dovercourt Lane
CityStateZip CodeCounty
Ormond BeachFL32174Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1064401339-6$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS9840Anesthesiology 

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
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Special Procedure Room 
Date of OccurrenceDate Reported to Insurer
11/27/20062/26/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Feeding tube placement for patient with tongue resection due to cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to appreciate anatomical deviation prior to placement of feeding tube.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to obtain adequate pre-anesthesia evaluation and failure to protect airway
Principal Injury Giving Rise To The Claim
Respiratory arrest, prolonged hypoxia
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
10/20/20092009 Ca 001658
County Suit Filed inDate of Final Disposition
Flagler6/25/2010
Other Defendants Involved in this Claim
Iwanski, D.O., Dorothy
Zak, III, MD, Jon
Memorial Hospital Flagler
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
4/27/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$850,000
Loss Adjust Expense Paid to Defense Counsel$52,469
All Other Loss Adjustment Expense Paid$4,351
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. Allan C Oglesby Medical Malpractice Lawsuits - Court Case # 05-000192CA

Indemnity Paid: $600,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200744573
Claim Number :HPFMOMP015906
Date Submitted :2/26/2007
 
Insurer Information
 
Insurer NameCoverage Type
Oglesby, Allan CPrimary
Insurer FEINProfessional License Number
59-0973502ME60915
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJudith AHenderson
Street Address
111 North Orlando Avenue
CityStateZip
Winter ParkFL32789
PhoneExtFaxE-Mail Address
(407) 975 - 1459 (407) 975 - 1570judith.henderson@ahss.org
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAllanCOglesby
Insurer TypeStreet Address of Practice
Self-Insurer61 Memorial Medical Parkway, Suite 3815
CityStateZip CodeCounty
Palm CoastFL32164Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
8528-2004$15,000,000$15,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60915Internal Medicine - 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
MEMORIAL HOSPITAL-WEST VOLUSIA100045
Location of Institutional InjuryOther Location of Institutional Injury
OtherPhysician Office
Date of OccurrenceDate Reported to Insurer
4/22/200411/22/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Routine checkup with lab work.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to follow up on elevated PSA resulted in delay diagnosis and prostate cancer.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Cancer.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/30/200405-000192CA
County Suit Filed inDate of Final Disposition
Flagler1/18/2006
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
12/19/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$600,000
Loss Adjust Expense Paid to Defense Counsel$26,864
All Other Loss Adjustment Expense Paid$8,177
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
Appropriate steps taken
 
Updates
 
No updates found.

 

 

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

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Dr. Steven J Brown Medical Malpractice Lawsuits - Court Case # 03-1168-CA Div 50

Indemnity Paid: $524,766.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643323
Claim Number :122788
Date Submitted :4/30/2008
 
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
IndividualStevenJBrown
Insurer TypeStreet Address of Practice
Licensed61 Memorial Medical Parkway, Suite 1-800-B
CityStateZip CodeCounty
Palm CoastFL32164Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP35873$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME68427Surgery - Obstetrics - Gynecology00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
N/A000000
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
7/11/20025/15/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lump in breast.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient sent for mammogram.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Breast cancer resulting in mastectomy.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/1/200303-1168-CA Div 50
County Suit Filed inDate of Final Disposition
Flagler11/16/2006
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
After appeal.
Final Method of Claim Disposition
Disposed of by Court
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/24/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$524,766
Loss Adjust Expense Paid to Defense Counsel$162,657
All Other Loss Adjustment Expense Paid$100,142
Injured Person's Total Non-Economic Loss$524,766
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured has discussed case with insurance company personnel, medical experts and defense counsel.
 
Updates
 
 
Date of Change:4/30/2008 10:57:24 AM
Reason for Change:Update to reflect indemnity payment, as well as additional legal fees an expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid37545100142
Indemnity Paid425000524766
Legal System StageAfter court verdict and prior to filing of notice of appeal.After appeal.
Amount of Loss Adjustment Expense Paid to Defense Counsel56758162657
Injured Person Total Non-Economic Loss0524766

 

 

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Dr. John Zak Medical Malpractice Lawsuits - Court Case # 2009CA 001658

Indemnity Paid: $450,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201057347
Claim Number :38308-01
Date Submitted :5/18/2010
 
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
IndividualJohn Zak
Insurer TypeStreet Address of Practice
Licensed21 Hospital Drive, Ste 250
CityStateZip CodeCounty
Palm CoastFL32164Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
15690$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME51680Surgery - Gastroenterology80274

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
Hospital Inpatient Facility 
Name of InstitutionCode
FLAGLER HOSPITAL100090
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
11/29/20062/19/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Placement of PEG tube and removal of nasogastric tube to prevent recurring infections.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Removal of nasogastric tube and placement of PEG tube under anesthesia.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Anoxic brain injury, impaired motor skills, memory defects.
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
10/15/20092009CA 001658
County Suit Filed inDate of Final Disposition
Flagler4/27/2010
Other Defendants Involved in this Claim
Iwanski, D.O., Dorothy
Memorial Hospital-Flagler, Inc.
Zimmet, D.O., Glenn
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
4/27/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$450,000
Loss Adjust Expense Paid to Defense Counsel$17,366
All Other Loss Adjustment Expense Paid$6,613
Injured Person's Total Non-Economic Loss$450,000
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. WILLIAM WANSA Medical Malpractice Lawsuits - Court Case # 2009 CA 003118

Indemnity Paid: $300,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470675
Claim Number :EMC-09-XS-257480
Date Submitted :5/1/2014
 
Insurer Information
 
Insurer NameCoverage Type
EmCare Holdings, Inc.Primary
Insurer FEINProfessional License Number
75-173235SI
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKathyAStockton
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 2404 (713) 461 - 8130kathy_stockton@westernlitigation.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualWILLIAM WANSA
Insurer TypeStreet Address of Practice
Self-Insurer49 SPRING MEADOWS DRIVE
CityStateZip CodeCounty
ORMOND BEACHFL32174Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
EMC-2009-Excess$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME80374Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
1/3/20087/21/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
HEADACHE
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
NEURO ASSESSMENT WAS DONE ALONG WITH CT SCAN
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
DISCHARGED WITH INSTRUCTIONS TO FOLLOW UP WITH NEUROLOGIST
Principal Injury Giving Rise To The Claim
CEREBRAL ISCHEMIC EVENT.
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
12/2/20092009 CA 003118
County Suit Filed inDate of Final Disposition
Flagler5/1/2014
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
4/8/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$300,000
Loss Adjust Expense Paid to Defense Counsel$81,199
All Other Loss Adjustment Expense Paid$21,435
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. INGRID WILLIAMS-LEGALL Medical Malpractice Lawsuits - Court Case # 2011-CA-001005

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201471012
Claim Number :EMC-FL-11-1148O7
Date Submitted :6/11/2014
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKathyAStockton
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 2404 (713) 461 - 8130kathy_stockton@westernlitigation.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualINGRID WILLIAMS-LEGALL
Insurer TypeStreet Address of Practice
Licensed157 BRITTANY LANE
CityStateZip CodeCounty
PALM COASTFL32137Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-9$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78455Emergency Medicine - No Major 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
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL (ORLANDO)100007
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
3/9/20107/18/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
ABDOMINAL AND CHEST DISCOMFPORT
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
TEST AND STUDIES, EXAM, LABS AND IMAGING STUDIES.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
NO MISDIAGNOSIS
Principal Injury Giving Rise To The Claim
LARGE HEMATOMA ON THE RIGHT UPPER QUADRANT AS WELL AS GI BLEEDING
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/30/20122011-CA-001005
County Suit Filed inDate of Final Disposition
Flagler5/15/2014
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
11/12/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$40,798
All Other Loss Adjustment Expense Paid$6,110
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. Utpal Desai Medical Malpractice Lawsuits - Court Case # 04-894-C

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200536471
Claim Number :236589
Date Submitted :8/30/2005
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJosie Maldonado
Street Address
The Doctors Company, 13450 West Sunrise Blvd., Suite 160
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(954) 858 - 0480 (954) 838 - 7480JMaldonado@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualUtpal Desai
Insurer TypeStreet Address of Practice
Licensed588 Sterthaus Avenue
CityStateZip CodeCounty
Ormond BeachFL32174Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
65161$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME82884Surgery - Thoracic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLAGLER HOSPITAL100219
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/17/20034/1/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Death due to multi-organ failure after surgery to repair abdominal aortic aneurysms.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Abdominal aortic aneurysm surgery.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient developed multi-system organ failure and never regained continuousness.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/6/200404-894-C
County Suit Filed inDate of Final Disposition
Flagler8/15/2005
Other Defendants Involved in this Claim
Emcare of Florida, Inc.
Florida Hospital-Flagler
Gonzalez, M.D., Gonzalo
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
8/18/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$0
All Other Loss Adjustment Expense Paid$61,000
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.

 

 

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

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Dr. Roy H Hinman Medical Malpractice Lawsuits - Court Case # 2011CA000166

Indemnity Paid: $249,999.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264519
Claim Number :2010234926
Date Submitted :8/9/2012
 
Insurer Information
 
Insurer NameCoverage Type
OCEANUS INSURANCE COMPANY, A RISK RETENTION GROUPPrimary
Insurer FEINProfessional License Number
20-1066914 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKarenMRichards
Street Address
111 WestPort Plaza Drive, 9th Floor
CityStateZip
St. LouisMO63146
PhoneExtFaxE-Mail Address
(314) 514 - 2570n/a(562) 492 - 1865Karen.Richards@sedgwickcms.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRoyHHinman
Insurer TypeStreet Address of Practice
Licensed100 Arricola Avenue
CityStateZip CodeCounty
St. AugustineFL32080St. Johns
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
01-2010-041$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME56729General Preventative Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSt. Johns
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
8/1/20109/28/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pt. was eventually referred for a hematuria workup including a CT Scan in April 2009 which showed a tumor involving her bladder.this was confirmed by a cystoscopy.She underwent a cystoscopy and transurathral resection bladder tumor and ultimately a total cystectomy.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Pt. presented in August 2008 and thereafter reporting urinary problems and blood in her urine.She alleged thta Dr. Hinman and his staff failed to evaluate, diagnose and treat the cause of her persistent hematuria and provide a timely referral to a urologist or conduct appropriate diagnostic analysis to determine her medical condition.
Diagnostic Code :202
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Pt. presented in August 2008 and thereafter reporting urinary problems and blood in her urine.She alleged thta Dr. Hinman and his staff failed to evaluate, diagnose and treat the cause of her persistent hematuria and provide a timely referral to a urologist or conduct appropriate diagnostic analysis to determine her medical condition.
Principal Injury Giving Rise To The Claim
Pt. was eventually referred for a hematuria workup including a CT Scan in April 2009 which showed a tumor involving her bladder.this was confirmed by a cystoscopy.She underwent a cystoscopy and transurathral resection bladder tumor and ultimately a total cystectomy.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/23/20112011CA000166
County Suit Filed inDate of Final Disposition
Flagler2/13/2012
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
2/13/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$249,999
Loss Adjust Expense Paid to Defense Counsel$100,517
All Other Loss Adjustment Expense Paid$2,200
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 Review
 
Updates
 
No updates found.

 

 

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Dr. ROBERT C BIANCO Medical Malpractice Lawsuits - Court Case # 03-1182-CA

Indemnity Paid: $175,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640964
Claim Number :269162
Date Submitted :6/7/2006
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKarinaLDobberstein
Street Address
5814 Reed Rd
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0490 (260) 486 - 0808karina.dobberstein@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualROBERTCBIANCO
Insurer TypeStreet Address of Practice
Licensed14 OFFICE PARK DR STE 1
CityStateZip CodeCounty
PALM COASTFL32137Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
682045$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME57906Cardiovascular Disease - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/24/20027/1/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
HEAVINESS IN CHEST
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
MEDICAL TREATMENT
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
IMPROPER TREATMENT
Principal Injury Giving Rise To The Claim
ADDITIONAL PAIN AND SUFFERING
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/17/200303-1182-CA
County Suit Filed inDate of Final Disposition
Flagler6/2/2006
Other Defendants Involved in this Claim
DELEON, AUGUSTO
FLORIDA HEALTHCARE PLAN, 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
6/2/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$175,000
Loss Adjust Expense Paid to Defense Counsel$46,157
All Other Loss Adjustment Expense Paid$25,637
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
NA
 
Updates
 
No updates found.

 

 

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Dr. Melchor E Gonzalez Medical Malpractice Lawsuits - Court Case # 2009 CA 001 764

Indemnity Paid: $150,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201058072
Claim Number :30093
Date Submitted :9/7/2010
 
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
IndividualMelchorEGonzalez
Insurer TypeStreet Address of Practice
Licensed335 Ocean Shore Blvd.
CityStateZip CodeCounty
Ormond BeachFL32176Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601476 05$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME72928Surgery - Cardiac 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLAGLER HOSPITAL100090
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
11/28/20074/3/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Complication of arterial injury following stent placement
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 properly manage recognized complication of stent placement
Principal Injury Giving Rise To The Claim
Hematoma
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/31/20092009 CA 001 764
County Suit Filed inDate of Final Disposition
Flagler8/17/2010
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
7/22/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$150,000
Loss Adjust Expense Paid to Defense Counsel$33,430
All Other Loss Adjustment Expense Paid$16,170
Injured Person's Total Non-Economic Loss$150,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$70,800$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:9/7/2010 1:08:55 PM
Reason for Change:Report updated to reflect court document final disposition date of 08/17/2010
 
Field ChangedFormer ValueNew Value
Date of Final Disposition22-JUL-1017-AUG-10

 

 

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Dr. MICHAEL GIBBONS Medical Malpractice Lawsuits - Court Case # 2013-CA-000082

Indemnity Paid: $125,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201471538
Claim Number :EMC-FL-12XS-257920
Date Submitted :8/5/2014
 
Insurer Information
 
Insurer NameCoverage Type
EmCare Holdings, Inc.Primary
Insurer FEINProfessional License Number
75-173235SI
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKathyAStockton
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 2404 (713) 461 - 8130kathy_stockton@westernlitigation.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMICHAEL GIBBONS
Insurer TypeStreet Address of Practice
Self-Insurer197 SAINT JOHNS FOREST BLVD
CityStateZip CodeCounty
JACKSONVILLEFL32259St. Johns
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
EMC-2012-Excess$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME101919Emergency Medicine - No Major 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
Emergency Room 
Name of InstitutionCode
FLAGLER HOSPITAL100219
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
4/16/201111/15/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
CHEST PAIN AFTER FALL
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
X-RAYS AND CT WERE TAKEN
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
INTERPRETED AS UNREMARKABLE
Principal Injury Giving Rise To The Claim
MYELOMA
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
2/7/20132013-CA-000082
County Suit Filed inDate of Final Disposition
Flagler8/5/2014
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
7/3/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$125,000
Loss Adjust Expense Paid to Defense Counsel$3,624
All Other Loss Adjustment Expense Paid$4,804
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. Anthony Martinez Medical Malpractice Lawsuits - Court Case # 05-001926CA

Indemnity Paid: $80,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200850342
Claim Number :31170-01
Date Submitted :7/29/2008
 
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
IndividualAnthony Martinez
Insurer TypeStreet Address of Practice
Licensed61 Memorial Medical Parkway, Ste 2802
CityStateZip CodeCounty
Palm CoastFL32164Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
46823$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME59010Surgery - Otorhinolaryngology80159

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
8/6/20037/26/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Tumor on right side of neck.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Incisional biopsy of tumor on right side of neck.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Neurological damage to right arm.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/5/200605-001926CA
County Suit Filed inDate of Final Disposition
Flagler7/8/2008
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 not subject to Arbitration.
Date of Payment
7/8/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$80,000
Loss Adjust Expense Paid to Defense Counsel$74,830
All Other Loss Adjustment Expense Paid$37,334
Injured Person's Total Non-Economic Loss$80,000
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. Florence Fruehan Medical Malpractice Lawsuits - Court Case # 2009-CA-001406

Indemnity Paid: $62,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264489
Claim Number :36224-01
Date Submitted :8/8/2012
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualFlorence Fruehan
Insurer TypeStreet Address of Practice
Licensed9 Pine Cone Dr., Suite 102
CityStateZip CodeCounty
Palm CoastFL32137Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
23488$250,000$750,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS5359Family Physicians or General Practitioners - No Surgery80239

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
3/20/200710/3/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented for employment physical and clearance.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to notify patient of CT results.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to advise patient of a mass on her lung.
Principal Injury Giving Rise To The Claim
Death.
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
8/5/20092009-CA-001406
County Suit Filed inDate of Final Disposition
Flagler7/20/2012
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/20/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$62,500
Loss Adjust Expense Paid to Defense Counsel$29,907
All Other Loss Adjustment Expense Paid$1,942
Injured Person's Total Non-Economic Loss$62,500
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. Kathleen M Hughes Medical Malpractice Lawsuits - Court Case # 02-1031-CA

Indemnity Paid: $54,039.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535552
Claim Number :15546
Date Submitted :6/20/2005
 
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
IndividualKathleenMHughes
Insurer TypeStreet Address of Practice
Licensed820 Prudential Dr., Ste. 713
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600109 02$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME45813Emergency Medicine - No Major Surgery2507

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
Emergency Room 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
4/23/20019/23/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Possible snakebite
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Evaluation
Diagnostic Code :989.5
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly treat injury.
Principal Injury Giving Rise To The Claim
Chronic lymphedema and osteonecrosis
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/15/200202-1031-CA
County Suit Filed inDate of Final Disposition
Flagler6/15/2005
Other Defendants Involved in this Claim
Smith, DO, Scott W
Memorial Hospital Flagler
Stage of Legal System at which Settlement was Reached or Award Made
After court verdict and prior to filing of notice of appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/15/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$54,039
Loss Adjust Expense Paid to Defense Counsel$74,040
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$54,039
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$25,000$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured.
 
Updates
 
No updates found.

 

 

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Dr. Ronald Bathaw Medical Malpractice Lawsuits - Court Case # 05-000338CA

Indemnity Paid: $50,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747406
Claim Number :31693-01
Date Submitted :10/22/2007
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRonald Bathaw
Insurer TypeStreet Address of Practice
LicensedP. O. Box 352077
CityStateZip CodeCounty
Palm CoastFL32135Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
10762$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME46366Surgery - Orthopedic80154

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
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
12/25/200211/30/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Transverse fracture through mid portion of patella with gross displacement of fragments, left patella.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Open reduction with internal fixation of left patella with tension band wiring technique and Steinmann pins.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Malunion of fracture of left patella.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/30/200505-000338CA
County Suit Filed inDate of Final Disposition
Flagler10/3/2007
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/3/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$50,000
Loss Adjust Expense Paid to Defense Counsel$14,638
All Other Loss Adjustment Expense Paid$11,157
Injured Person's Total Non-Economic Loss$50,000
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. Paul Cavalluzzo Medical Malpractice Lawsuits - Court Case # 2011 CA 000253

Indemnity Paid: $33,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201162370
Claim Number :40473-01
Date Submitted :11/22/2011
 
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
IndividualPaul Cavalluzzo
Insurer TypeStreet Address of Practice
Licensed17 Old Kings Road North, Ste H
CityStateZip CodeCounty
Palm CoastFL32137Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
56138$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Dentistry 
License NumberSpecialty Code & ClassificationCertification Number
DN9097Dental General Practice - NOC80211

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
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
12/1/20097/28/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented to have restorative dental work performed.Patient received four implants and two bridges.The patient had underlying periodontal disease.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to treat underlying periodontal disease, causing implants to fail.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Alleged failure to treat the patient's periodontal disease, causing implants to fail.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/31/20112011 CA 000253
County Suit Filed inDate of Final Disposition
Flagler11/3/2011
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
11/3/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$33,000
Loss Adjust Expense Paid to Defense Counsel$16,312
All Other Loss Adjustment Expense Paid$2,465
Injured Person's Total Non-Economic Loss$33,000
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. Gonzalo C Gonzalez Medical Malpractice Lawsuits - Court Case # 04-894-CA

Indemnity Paid: $30,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640438
Claim Number :EMC-AO-04-32675
Date Submitted :5/2/2006
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancy  Thomas
Street Address
2000 West Sam Houston Parkway South, 19th Floor; One Briarlake Plaza
CityStateZip
HoustonTX77042-361
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGonzaloCGonzalez
Insurer TypeStreet Address of Practice
Licensed11 Cedar Point Ct.
CityStateZip CodeCounty
Palm CoastFL32164Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-2$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME66849Family Physicians or General Practitioners - 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
Emergency Room 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/12/20033/24/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Abdominal aneurysm
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Triaged adn noted to have elevated BP.Doctor ordered Morphine Sulphate and Nitro drip.He suspected aortic abdominal aortic aneurysm, however cardiovascular surgeon disagreed resulting in delay of treatment for same.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis
Principal Injury Giving Rise To The Claim
Death; plaintiffs allege failure to advocate strongly enough for patient.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/7/200404-894-CA
County Suit Filed inDate of Final Disposition
Flagler4/27/2006
Other Defendants Involved in this Claim
Memorial Hospital Flagler
Emcare of Florida
Desai, M.D., Utpal
Coastal Cardiovascular Associates
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$30,000
Loss Adjust Expense Paid to Defense Counsel$92,327
All Other Loss Adjustment Expense Paid$24,306
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. Scott W Smith Medical Malpractice Lawsuits - Court Case # 02-1031-CA

Indemnity Paid: $13,510.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535553
Claim Number :16296
Date Submitted :6/20/2005
 
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
IndividualScottWSmith
Insurer TypeStreet Address of Practice
Licensed820 Prudential Drive, Suite 713
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600109 02$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
OS7084Emergency Medicine - No Major Surgery1175

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
Emergency Room 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
4/23/20019/23/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Possible snakebite
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Evaluation
Diagnostic Code :989.5
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly treat injury
Principal Injury Giving Rise To The Claim
Chronic lymphedema and osteonecrosis
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/15/200202-1031-CA
County Suit Filed inDate of Final Disposition
Flagler6/15/2005
Other Defendants Involved in this Claim
Hughes, Kathleen M
Memorial Hospital Flagler
Stage of Legal System at which Settlement was Reached or Award Made
After court verdict and prior to filing of notice of appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/15/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$13,510
Loss Adjust Expense Paid to Defense Counsel$179,314
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$13,510
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$25,000$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. AUGUSTO R DE LEON Medical Malpractice Lawsuits - Court Case # 03-1182-CA

Indemnity Paid: $10,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200641164
Claim Number :A03-28802-02
Date Submitted :6/23/2006
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCheriMMontague
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAUGUSTORDE LEON
Insurer TypeStreet Address of Practice
Licensed1340 Ridgewood Avenue
CityStateZip CodeCounty
Daytona BeachFL32117Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
38490$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME66795Internal Medicine - No Surgery80257

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL - FLAGLER100118
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
3/24/20027/1/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Severe chest pain-angina.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient in process of being transferred to another hospital for catheterization.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/21/200303-1182-CA
County Suit Filed inDate of Final Disposition
Flagler5/31/2006
Other Defendants Involved in this Claim
Memorial Hospital-Flagler
Bianco, M.D., Robert
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
5/31/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$10,000
Loss Adjust Expense Paid to Defense Counsel$31,186
All Other Loss Adjustment Expense Paid$23,253
Injured Person's Total Non-Economic Loss$10,000
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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