Medical Malpractice Cases

Medical Malpractice Cases In Lake County Florida

Dr. Ivan J Wortman Medical Malpractice Lawsuits - Court Case # 03CA3561

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640476
Claim Number :852271
Date Submitted :2/3/2009
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualPamelaAPrudlow
Street Address
5814 Reed Road
CityStateZip
Ft. WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0370 (260) 486 - 0785pamela.prudlow@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualIvanJWortman
Insurer TypeStreet Address of Practice
Licensed6129 Linneal Beach Drive
CityStateZip CodeCounty
ApopkaFL32703Seminole
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
H00218$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME63259Emergency Medicine - Including Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SOUTH LAKE HOSPITAL100051
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/2/20016/11/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Complaints of headache, shoulder & neck pain, fever & vomiting.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Treatment for otitis media, cervical pain & functional stress headache.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose Pseudotumor Cerebri.
Principal Injury Giving Rise To The Claim
Permanent 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
10/30/200303CA3561
County Suit Filed inDate of Final Disposition
Lake4/18/2006
Other Defendants Involved in this Claim
Emergency Physicians of Central Florida
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
4/18/2006
 
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$44,347
All Other Loss Adjustment Expense Paid$19,033
Injured Person's Total Non-Economic Loss$0
Deductible$100,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$355,171
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
n/a
 
Updates
 
 
Date of Change:2/3/2009 3:29:10 PM
Reason for Change:Update to legal fees & expenses paid.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel3054444347
All Other Loss Adjustment Expense Paid2773619033

 

 

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Dr. Miguel Bryce Medical Malpractice Lawsuits - Court Case # 05-CA-1212

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747555
Claim Number :21299
Date Submitted :12/12/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMiguel Bryce
Insurer TypeStreet Address of Practice
Licensed1879 Nightingale Lane
CityStateZip CodeCounty
TavaresFL32778Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600095 05$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME84628Surgery - Cardiovascular Disease73701

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL WATERMAN100057
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
3/26/20031/3/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Sinus bradycardia with sinus arrest and ventricular escape rhythm
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Implant dual chamber pacemaker
Diagnostic Code :353.8
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged improper placement of pacemaker lead
Principal Injury Giving Rise To The Claim
Stroke, hemiplegia, speech impairment, memory loss
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/25/200505-CA-1212
County Suit Filed inDate of Final Disposition
Lake11/26/2007
Other Defendants Involved in this Claim
Cardiovascular Associates of Lake County
Cardiovascular Associates of Central Florida
Medtronics, Inc.
Cacodcar, MD, Surexa S
Drummond, Douglas
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
10/30/2007
 
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$92,672
All Other Loss Adjustment Expense Paid$31,704
Injured Person's Total Non-Economic Loss$1,000,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$150,000$0
Wage Loss$0$754,000
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:12/12/2007 1:07:49 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 11/26/07
 
Field ChangedFormer ValueNew Value
Date of Final Disposition18-OCT-0726-NOV-07

 

 

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Dr. Srinivas Attanti Medical Malpractice Lawsuits - Court Case # 10-CA-1480

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201159557
Claim Number :30701/32360
Date Submitted :3/25/2011
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualSrinivas Attanti
Insurer TypeStreet Address of Practice
Licensed308 W. Highland Blvd.
CityStateZip CodeCounty
InvernessFL34452Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1602338 01$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME90705Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Special Procedure Room 
Date of OccurrenceDate Reported to Insurer
12/3/20076/10/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Carotid artery
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Doppler study
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform and interpret carotid artery Doppler study
Principal Injury Giving Rise To The Claim
Stroke
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
3/19/201010-CA-1480
County Suit Filed inDate of Final Disposition
Lake2/3/2011
Other Defendants Involved in this Claim
Hinkle, Ken
Citrus Cardiology Consultants, P.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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
1/6/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$23,178
All Other Loss Adjustment Expense Paid$9,884
Injured Person's Total Non-Economic Loss$800,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$124,328$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:3/25/2011 2:38:28 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 02/03/11
 
Field ChangedFormer ValueNew Value
Date of Final Disposition06-JAN-1103-FEB-11

 

 

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Dr. Nicholai Zelneronok Medical Malpractice Lawsuits - Court Case # 2013-CA-002314

Indemnity Paid: $800,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470505
Claim Number :43575
Date Submitted :7/11/2014
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualNicholai Zelneronok
Insurer TypeStreet Address of Practice
Licensed13 Sanchez Avenue
CityStateZip CodeCounty
Saint AugustineFL32084St. Johns
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PRF 1411245 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME34231Surgery - Urological 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSt. 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
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
2/3/20111/7/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lung cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to follow-up on pre-procedure chest x-ray
Principal Injury Giving Rise To The Claim
Lung cancer
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/31/20132013-CA-002314
County Suit Filed inDate of Final Disposition
Lake5/19/2014
Other Defendants Involved in this Claim
Central Florida Urology Specialists
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
4/3/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$800,000
Loss Adjust Expense Paid to Defense Counsel$19,399
All Other Loss Adjustment Expense Paid$10,970
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$100,000$0
Wage Loss$0$50,000
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:7/11/2014 10:51:16 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 05/19/14
 
Field ChangedFormer ValueNew Value
Date of Final Disposition03-APR-1419-MAY-14

 

 

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Dr. Ivan J Wortman Medical Malpractice Lawsuits - Court Case # 03CA3561

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640477
Claim Number :860861
Date Submitted :5/4/2006
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Excess
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualPamelaAPrudlow
Street Address
5814 Reed Road
CityStateZip
Ft. WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0370 (260) 486 - 0785pamela.prudlow@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualIvanJWortman
Insurer TypeStreet Address of Practice
Licensed6129 Linneal Beach Drive
CityStateZip CodeCounty
ApopkaFL32703Seminole
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
H00219$7,000,000$7,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME63259Emergency Medicine - Including Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SOUTH LAKE HOSPITAL100051
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/2/20016/11/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Complaints of headache, shoulder & neck pain, fever & vomiting.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Treatment for otitis media, cervical pain & functional stress headache.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose Pseudotumor Cerebri.
Principal Injury Giving Rise To The Claim
Permanent 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
10/30/200303CA3561
County Suit Filed inDate of Final Disposition
Lake4/18/2006
Other Defendants Involved in this Claim
Emergency Physicians of Central Florida
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
4/18/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$750,000
Loss Adjust Expense Paid to Defense Counsel$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$355,171
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. Mark D Jacobson Medical Malpractice Lawsuits - Court Case # 2004-CA-366

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746961
Claim Number :18523
Date Submitted :9/17/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMarkDJacobson
Insurer TypeStreet Address of Practice
Licensed801 East Dixie Avenue #104
CityStateZip CodeCounty
LeesburgFL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600001 04$2,000,000$4,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME67158Radiology - Diagnostic - Minor Surgery3605

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
7/23/20039/16/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Right superficial femoral arterial occlusive disease
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Percutaneous angioplasty
Diagnostic Code :1942.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly manage patient after angioplasty
Principal Injury Giving Rise To The Claim
Petroperitoneal hematoma and extravasation
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/28/20042004-CA-366
County Suit Filed inDate of Final Disposition
Lake8/10/2007
Other Defendants Involved in this Claim
Paymani, MD, Mahrad
Hessami, MD, Miratiqullah
Radiology Associates of Central Florida
Central Florida Health Care Development Corp.
Leesburg Regional Medial 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
9/7/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$750,000
Loss Adjust Expense Paid to Defense Counsel$101,501
All Other Loss Adjustment Expense Paid$36,134
Injured Person's Total Non-Economic Loss$750,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$70,000$0
Wage Loss$0$250,000
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. RAYMOND COLOM Medical Malpractice Lawsuits - Court Case # 11CA3441

Indemnity Paid: $700,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264452
Claim Number :472
Date Submitted :7/30/2012
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJaclynSAdler
Street Address
9300 NW 14th Street
CityStateZip
Pembroke PinesFL33024
PhoneExtFaxE-Mail Address
(954) 559 - 3131 (954) 431 - 8388Jadjuster2@aol.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRAYMOND COLOM
Insurer TypeStreet Address of Practice
Licensed600 East Dixie Avenue
CityStateZip CodeCounty
Leesburg FL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1064385823-5$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME70197Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/19/20107/1/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
7-month old male with a history of a chromosomal deficiency, Glutaric Acidemia Type I (GA-I), was brought to the ED of Leesburg Regional Medical Center by his mother who reported vomiting since the previous day and a fever the previous day.He was discharged with diagnoses of vomiting and possible viral illness.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
There was no operation, diagnostic, or treatment procedure that caused an injury.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was no misdiagnosis.
Principal Injury Giving Rise To The Claim
A 7-month old male with a history of a chromosomal deficiency, Glutaric Acidemia Type I (GA-I), was brought to the ED of Leesburg Regional Medical Center by his mother who reported vomiting since the previous day and a fever the previous day. The child was seen in the ED by Raymond Colom, MD and when his shift ended, care was taken over by another physician, who discharged the patient with clinical impressions of (1) Vomiting (2) Possible Viral illness.The following day, the child was seen at another hospital with lethargy and hypotonia.He was then transferred to a tertiary children's hospital for treatment. There he was additionally diagnosed with encephalopathy and seizures.He was discharged on 3/24/10.The child suffered damage to the basil ganglia of his brain resulting in severe developmental delays.It was alleged that these damages were due to delays in treatment of the GA-1. There was a dispute over whether or not the patient's mother providedDr. Colom (and the physician who saw the child after Dr. Colom went off-duty) with an "Emergency Medical Protocol" form that explained the child's GA-1 condition and the treatment protocols that were required for him.The claim was disputed.A compromise settlement was reached without admission of liability.
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
12/16/201111CA3441
County Suit Filed inDate of Final Disposition
Lake7/19/2012
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
7/19/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$700,000
Loss Adjust Expense Paid to Defense Counsel$5,614
All Other Loss Adjustment Expense Paid$2,122
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. Yin Luk Medical Malpractice Lawsuits - Court Case # 2013-CA-001734

Indemnity Paid: $700,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201369238
Claim Number :301662
Date Submitted :12/18/2013
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualTiffanyDTaylor
Street Address
13450 West Sunrise Blvd
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(877) 320 - 0748  TTaylor@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualYin Luk
Insurer TypeStreet Address of Practice
Licensed601 East Dixie Avenue Suite 801
CityStateZip CodeCounty
LeesburgFL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0615277$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME101492Surgery - General 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
N/A000000
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
11/11/201112/20/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient underwenta cholesystectomy.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged injury to patient's bile duct system during cholesystectomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Alleged injury to patient's bile duct system during cholesystectomy.
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
6/4/20132013-CA-001734
County Suit Filed inDate of Final Disposition
Lake12/11/2013
Other Defendants Involved in this Claim
Leesburg Regional Medical Center
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
OtherVoluntary Dismissal
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/6/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$700,000
Loss Adjust Expense Paid to Defense Counsel$27,000
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$600,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$100,000$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Unknown
 
Updates
 
No updates found.

 

 

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

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Dr. Robert A Honegger Medical Malpractice Lawsuits - Court Case # 2010-CA-004925

Indemnity Paid: $607,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201161615
Claim Number :273
Date Submitted :9/14/2011
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJaclynSAdler
Street Address
9300 NW 14th Street
CityStateZip
Pembroke PinesFL33024
PhoneExtFaxE-Mail Address
(954) 559 - 3131 (954) 431 - 8388Jadjuster2@aol.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertAHonegger
Insurer TypeStreet Address of Practice
Licensed600 E. Dixie Avenue
CityStateZip CodeCounty
LeesburgFL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1064385823-4$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME46950Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/25/20086/22/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The final diagnosis was a benign tumor at the T9 vertebral level with cord compression. (The patient presented with varying complaints of low back pain, abdominal pain, weak and buckling legs, and constipation.)
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
There was no operation, diagnostic, or treatment procedure rendered that caused an injury.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
The patient was diagnosed with left leg sciatica with numbness.
Principal Injury Giving Rise To The Claim
The patient is now paraplegic.
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
10/28/20102010-CA-004925
County Suit Filed inDate of Final Disposition
Lake9/1/2011
Other Defendants Involved in this Claim
Leesburg Regional Medical Center
Florida Emergency Physicians Kang & Assoc.
Rivera, Alberto R
Florida Waterman Hospital
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/1/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$607,500
Loss Adjust Expense Paid to Defense Counsel$20,161,000
All Other Loss Adjustment Expense Paid$3,147,000
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.

 

 

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Dr. Fouad Shami Medical Malpractice Lawsuits - Court Case # 2010-CA-000023

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201160818
Claim Number :09-08-0173-A
Date Submitted :6/15/2011
 
Insurer Information
 
Insurer NameCoverage Type
FD INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
20-3704679 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualLinda Collins
Street Address
4655 Salisbury Road, Suite 110
CityStateZip
JacksonvilleFL32256
PhoneExtFaxE-Mail Address
(904) 296 - 2887214(904) 296 - 8919lcollins@fldic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualFouad Shami
Insurer TypeStreet Address of Practice
Licensed1901 SE 18th Avenue #300
CityStateZip CodeCounty
OcalaFL34471Marion
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MG000585$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME20978Surgery - Urological 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
1/12/200811/3/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the ER complaining of nausea, chills, vomiting and right flank pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Labs and CT scan.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose and treat patient's true condition.
Principal Injury Giving Rise To The Claim
Loss of fingers and toes due to sepsis.
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
2/8/20102010-CA-000023
County Suit Filed inDate of Final Disposition
Lake5/24/2011
Other Defendants Involved in this Claim
Reddy, M.D., Movva
Leesburg Regional Medical Center
Simons, PA-C, Amy
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/6/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$59,921
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Circumstances of this case have been discussed with the Insured and Risk Management was notified.Risk Management has discussed the case with the Insured.
 
Updates
 
No updates found.

 

 

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Dr. JUDITH MILSTEAD Medical Malpractice Lawsuits - Court Case # 99-1204CA

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537941
Claim Number :98-0277
Date Submitted :11/3/2005
 
Insurer Information
 
Insurer NameCoverage Type
CLARENDON NATIONAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
52-0266645 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKim Cote
Street Address
2000 W. Sam Houston Parkway South
CityStateZip
HoustonTX77042
PhoneExtFaxE-Mail Address
(713) 722 - 16481648(713) 243 - 7311kim_cote@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJUDITH MILSTEAD
Insurer TypeStreet Address of Practice
Licensed601 E DIXIE AVE
CityStateZip CodeCounty
LEESBURGFL34748-5953Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
CMP0005854$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME41306Otorhinolaryngology - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/27/19971/22/1999
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
DIAGNOSED W/CHRONIC SINUSITIS & NASAL SEPTAL DEVIATION; CT SCAN SHOWED BILATERAL OSTEOMEATAL COMPLEX DISEASE & HYPERTROPHIC INFERIOR TURBINATE.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
DOCTOR PERFORMED AN ANTERIOR ETHMOIDECTOMIES W/ANTROSTOMIES; SEPTOPLASTY & BILATERAL PARTIAL RESECTION OF INFERIOR TURBINATES.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
NO MISDIAGNOSIS
Principal Injury Giving Rise To The Claim
ALLEGED FAILURE TO PROPERLY MANAGE PATIENT'S HYPOXIA; DELAYED ADEQUATE MECHANICAL VENTILATION & INSUFFICIENT POST-OP CARE
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/19/199999-1204CA
County Suit Filed inDate of Final Disposition
Lake10/3/2002
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500,000
Loss Adjust Expense Paid to Defense Counsel$106,248
All Other Loss Adjustment Expense Paid$7,813
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. Jeffrey D Baumann Medical Malpractice Lawsuits - Court Case # 12-CA-2746

Indemnity Paid: $475,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201367631
Claim Number :5149108-01
Date Submitted :9/23/2013
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualSusanKSpielman
Street Address
5814 Reed Road
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0340  reportaclaim@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJeffreyDBaumann
Insurer TypeStreet Address of Practice
Licensed12 South Park Ave
CityStateZip CodeCounty
ApopkaFL32703Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
716981$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME45010Surgery - Opthalmology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
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
10/8/20084/10/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Nevus right eye
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Exam
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose ocular melanoma
Principal Injury Giving Rise To The Claim
Metastasis resulting in death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/13/201212-CA-2746
County Suit Filed inDate of Final Disposition
Lake6/17/2013
Other Defendants Involved in this Claim
Mid-Florida Eye Center PA
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/17/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$475,000
Loss Adjust Expense Paid to Defense Counsel$3,621
All Other Loss Adjustment Expense Paid$1,015
Injured Person's Total Non-Economic Loss$400,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
 
Date of Change:9/23/2013 3:45:38 PM
Reason for Change:Update ALE
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel20113621
All Other Loss Adjustment Expense Paid7751015

 

 

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Dr. Jeffrey D Baumann Medical Malpractice Lawsuits - Court Case # 12-CA-2746

Indemnity Paid: $475,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201367632
Claim Number :5149108-01
Date Submitted :1/27/2014
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualSusanKSpielman
Street Address
5814 Reed Road
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0340  reportaclaim@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJeffreyDBaumann
Insurer TypeStreet Address of Practice
Licensed12 South Park Ave
CityStateZip CodeCounty
ApopkaFL32703Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
716981$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME45010Surgery - Opthalmology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
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
10/8/20084/10/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Nevus right eye
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Exam
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to diagnose ocular melanoma
Principal Injury Giving Rise To The Claim
Metastasis resulting in death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/13/201212-CA-2746
County Suit Filed inDate of Final Disposition
Lake6/17/2013
Other Defendants Involved in this Claim
Mid-Florida Eye Center PA
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/17/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$475,000
Loss Adjust Expense Paid to Defense Counsel$5,274
All Other Loss Adjustment Expense Paid$1,612
Injured Person's Total Non-Economic Loss$400,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
 
Date of Change:1/27/2014 4:16:52 PM
Reason for Change:ALE UPDATE
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel20115274
All Other Loss Adjustment Expense Paid7751612

 

 

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Dr. PHILLIP DASCHER Medical Malpractice Lawsuits - Court Case # 2003CA1594

Indemnity Paid: $450,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200433217
Claim Number :19371-01
Date Submitted :5/11/2007
 
Insurer Information
 
Insurer NameCoverage Type
AMERICAN PHYSICIANS ASSURANCE CORPORATIONPrimary
Insurer FEINProfessional License Number
38-2102867 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualChristine Sampson
Street Address
200 East Gaines Street
CityStateZip
TallahasseeFL32399
PhoneExtFaxE-Mail Address
(850) 413 - 5358 (850) 921 - 8243Christine.Sampson@fldfs.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPHILLIP DASCHER
Insurer TypeStreet Address of Practice
Licensed720 N BAY ST
CityStateZip CodeCounty
EUSTISFL32726-2964Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
125720$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME32039Surgery - GeneralN/A

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL WATERMAN100057
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
12/12/200112/5/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
PATIENT HAD INFLAMED SEVERE ACUTE CHOLECYSTITIS AND CHOLELITHIASIS.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
INSURED PERFORMED A LAPAROSCOPIC CHOLECSYTECTOMY.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
N/A
Principal Injury Giving Rise To The Claim
BILE LEAKAGE WHICH REQUIRED EXTENSIVE RECONSTRUCTIVE SURGERY.
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
5/16/20032003CA1594
County Suit Filed inDate of Final Disposition
Lake10/26/2004
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/14/2004
 
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$0
All Other Loss Adjustment Expense Paid$0
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
INSURED CONSULTED WITH DEFENSE COUNSEL AND CLAIMS PERSONNEL REGARDING THIS MATTER.
 
Updates
 
 
Date of Change:10/19/2005 11:13:38 AM
Reason for Change:made minor changes.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel037844
All Other Loss Adjustment Expense Paid018121
 
Date of Change:5/11/2007 2:43:30 PM
Reason for Change:OIR updating Historical Closed Claim data.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel378440
Portal User Namesteffanie simonChristine Sampson
All Other Loss Adjustment Expense Paid181210

 

 

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Dr. Minta S Tauer Medical Malpractice Lawsuits - Court Case # 03CA2821

Indemnity Paid: $435,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200642819
Claim Number :40-009207
Date Submitted :10/20/2006
 
Insurer Information
 
Insurer NameCoverage Type
TRUCK INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
95-2575892 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualRichardAJones
Street Address
4680 Wilshire Blvd., 6th Floor
CityStateZip
Los AngelesCA90010
PhoneExtFaxE-Mail Address
(714) 633 - 8331 (714) 633 - 1226rich.jones@farmersinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMintaSTauer
Insurer TypeStreet Address of Practice
Licensed1983 Morritts Court
CityStateZip CodeCounty
EustisFL32726Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0117776130000$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS5869Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
8/20/200211/27/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presents with a history of multiple wasp stings and small laceration to the occipatal region of the head.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Treatment for the wasp stings and instructions on discharge.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to obtain a CT and failure to diagnose an epidural bleed and a frontal hematoma.
Principal Injury Giving Rise To The Claim
Neurologicial damage .
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
8/26/200303CA2821
County Suit Filed inDate of Final Disposition
Lake9/26/2006
Other Defendants Involved in this Claim
Leesburg Regional Medical Center
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/19/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$435,000
Loss Adjust Expense Paid to Defense Counsel$3,603
All Other Loss Adjustment Expense Paid$6,057
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$116,000$0
Wage Loss$54,000$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured does not purchase risk management services.
 
Updates
 
No updates found.

 

 

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Dr. Roger E Bassin Medical Malpractice Lawsuits - Court Case # 2010CA004840

Indemnity Paid: $350,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201161805
Claim Number :7382
Date Submitted :10/7/2011
 
Insurer Information
 
Insurer NameCoverage Type
OPHTHALMIC MUTUAL INSURANCE COMPANY (A R.R.G.)Primary
Insurer FEINProfessional License Number
94-3047990 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualRogerEBassin
Street Address
1705 Berglund Lane, Suite 103
CityStateZip
VieraFL32940
PhoneExtFaxE-Mail Address
(321) 255 - 0025 (321) 255 - 0027christine@drbassin.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRogerEBassin
Insurer TypeStreet Address of Practice
Licensed1705 Berglund Lane, Suite 103
CityStateZip CodeCounty
VieraFL32940Brevard
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
OMC0009888$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85585Surgery - Opthalmology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOrange
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
Operating Suite 
Date of OccurrenceDate Reported to Insurer
4/14/20107/15/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
pt was diagnosed with having retrobulbar hematoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
patient had facelift and blepharplasty
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
pt was diagnosed with having retrobulbar hematoma
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/1/20102010CA004840
County Suit Filed inDate of Final Disposition
Lake5/5/2011
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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
5/5/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$350,000
Loss Adjust Expense Paid to Defense Counsel$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
Office is in contact with patients the evening of their procedure for follow-up care in addition tonext day for post surgical followup. Continuing to provide additional patient instruction to patients prior to surgery on awareness of post surgical complications.
 
Updates
 
No updates found.

 

 

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

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Dr. Robert Purdon Medical Malpractice Lawsuits - Court Case # 2010 CA 5115

Indemnity Paid: $350,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201263092
Claim Number :40390-01
Date Submitted :3/9/2012
 
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
IndividualRobert Purdon
Insurer TypeStreet Address of Practice
Licensed4000 Waterman Way
CityStateZip CodeCounty
TavaresFL32778Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
102700$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME43489Radiology - therapeutic - no surgery80425

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Patient's Home 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
2/29/20087/2/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient complained of mass in neck; he was ultimately diagnosed with squamous cell carcinoma in the base of his tongue.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
An alleged excessive dose of Fentanyl caused his death.
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
11/24/20102010 CA 5115
County Suit Filed inDate of Final Disposition
Lake2/27/2012
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
2/27/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$350,000
Loss Adjust Expense Paid to Defense Counsel$9,840
All Other Loss Adjustment Expense Paid$2,184
Injured Person's Total Non-Economic Loss$350,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
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. Eze D Uche Medical Malpractice Lawsuits - Court Case # 07CA839

Indemnity Paid: $350,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200952556
Claim Number :24156
Date Submitted :2/25/2009
 
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
IndividualEzeDUche
Insurer TypeStreet Address of Practice
Licensed1020 North Boulevard East
CityStateZip CodeCounty
LeesburgFL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601962 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME73420Cardiovascular Disease - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Patient's Home 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
1/6/20067/18/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Arteriosclerotic and hypertensive heart disease
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Stress test
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose CAD
Principal Injury Giving Rise To The Claim
Thrombosis LAD coronary artery
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/14/200707CA839
County Suit Filed inDate of Final Disposition
Lake2/5/2009
Other Defendants Involved in this Claim
Foster, MD, Larry D
Proud, MD, Christina
Leesburg Family Medicine
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
1/14/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$350,000
Loss Adjust Expense Paid to Defense Counsel$40,704
All Other Loss Adjustment Expense Paid$10,530
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$12,122$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:2/25/2009 2:39:13 PM
Reason for Change:Report updated to reflect Court Document Final Disposition Date of 02/05/09
 
Field ChangedFormer ValueNew Value
Date of Final Disposition14-JAN-0905-FEB-09

 

 

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Dr. Raoul D Maizel Medical Malpractice Lawsuits - Court Case # 200CA512

Indemnity Paid: $300,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200432261
Claim Number :501336
Date Submitted :7/30/2004
 
Insurer Information
 
Insurer NameCoverage Type
AMERICAN HEALTHCARE INDEMNITY COMPANYPrimary
Insurer FEINProfessional License Number
59-2048400 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualTerry MBinns
Street Address
1888 Century Park East, Suite 800
CityStateZip
Los AngelesCA90067
PhoneExtFaxE-Mail Address
(310) 556 - 7488 (310) 556 - 7400Tbinns@scpieahi.jcom
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRaoulDMaizel
Insurer TypeStreet Address of Practice
Licensed17560 HIGHWAY 441
CityStateZip CodeCounty
MOUNT DORAFL32757-6711Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
22000523$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60040Surgery - OpthalmologyUNK

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL WATERMAN100057
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
2/28/20009/25/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Detached retina, right eye
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Operation=Pneumoretinopexy
Diagnostic Code :Unk
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Loss of vision and removal of right eye.
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
2/15/2002200CA512
County Suit Filed inDate of Final Disposition
Lake7/28/2004
Other Defendants Involved in this Claim
Baumann, PLanzo, Maizel, Goldey, P.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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/28/2004
 
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$45,000
All Other Loss Adjustment Expense Paid$1,371
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$33,315$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Interview with investigator and defense counsel, answer interrogatories, deposition.
 
Updates
 
No updates found.

 

 

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Dr. Austin Regal Medical Malpractice Lawsuits - Court Case # 11CA3441

Indemnity Paid: $300,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264453
Claim Number :472-A
Date Submitted :7/30/2012
 
Insurer Information
 
Insurer NameCoverage Type
COLUMBIA CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
47-0490411 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJaclynSAdler
Street Address
9300 NW 14th Street
CityStateZip
Pembroke PinesFL33024
PhoneExtFaxE-Mail Address
(954) 559 - 3131 (954) 431 - 8388Jadjuster2@aol.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAustin Regal
Insurer TypeStreet Address of Practice
Licensed600 E. Dixie Avenue
CityStateZip CodeCounty
Leesburg FL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1064385823-5$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS3411Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
LEESBURG REGIONAL MEDICAL CENTER100084
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/19/20107/1/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
7-month old male with a history of a chromosomal deficiency, Glutaric Acidemia Type I (GA-I) was brought to the ED of Leesburg Regional Medical Center by his mother who reported vomiting since the previous day and a fever the previous day. He was discharged with a diagnosis of vomiting and possible viral illness.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
There was no operation, diagnostic or treatment procedure that caused an injury.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was no misdiagnosis.
Principal Injury Giving Rise To The Claim
A 7-month old male with a history of a chromosomal deficiency, Glutaric Acidemia Type I (GA-I), was brought to the ED of Leesburg Regional Medical Center by his mother who reported vomiting since the previous day and a fever the previous day. The child was seen in the ED by another physician and when his shift ended, care was taken over by Austin Regal DO, who discharged the patient with clinical impressions of (1) Vomiting (2) Possible Viral illness.The following day, the child was seen at another hospital with lethargy and hypotonia.He was then transferred to a tertiary children's hospital for treatment. There he was additionally diagnosed with encephalopathy and seizures.He was discharged on 3/24/10.The child suffered damage to the basil ganglia of his brain resulting in severe developmental delays.It was alleged that these damages were due to delays in treatment of the GA-1. There was a dispute over whether or not the patient's mother provided the first physician who saw the patient and Dr. Regal with an "Emergency Medical Protocol" form that explained the child's GA-1 condition and the treatment protocols that were required for him.The claim was disputed.A compromise settlement was reached without admission of liability.
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
12/16/201111CA3441
County Suit Filed inDate of Final Disposition
Lake7/19/2012
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
7/19/2012
 
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$5,614
All Other Loss Adjustment Expense Paid$2,122
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. Timothy Reed Medical Malpractice Lawsuits - Court Case # 12CA381

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264477
Claim Number :41333-01
Date Submitted :8/6/2012
 
Insurer Information
 
Insurer NameCoverage Type
ANESTHESIOLOGISTS PROFESSIONAL ASSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
59-2820748 
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
IndividualTimothy Reed
Insurer TypeStreet Address of Practice
Licensed600 East Dixie Avenue
CityStateZip CodeCounty
LeesburgFL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
98708$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME84184Anesthesiology80151

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSumter
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
VILLAGES REGIONAL HOSPITAL, THE23960032
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
1/24/20112/22/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Fractured right hip.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Repair of fractured right hip.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
After administration of Morphine, the patient suffered a cardiac arrest requiring resuscitation.Post event, the patient was diagnosed with an anoxic injury.
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
2/13/201212CA381
County Suit Filed inDate of Final Disposition
Lake7/11/2012
Other Defendants Involved in this Claim
Lake County Anesthesia Associates, P.A.
The Villages Regional Hospial
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/11/2012
 
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$1,500
All Other Loss Adjustment Expense Paid$5,515
Injured Person's Total Non-Economic Loss$250,000
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. RAMASWAMI KRISHNAN Medical Malpractice Lawsuits - Court Case # 11-CA-518

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201366323
Claim Number :10-0019
Date Submitted :3/5/2013
 
Insurer Information
 
Insurer NameCoverage Type
PHYSICIANS PROFESSIONAL LIABILITY RISK RETENTION GROUP, INC.Primary
Insurer FEINProfessional License Number
33-1010508 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJack  Heda
Street Address
1806 N. Flamingo Road, Suite 339
CityStateZip
Pembroke Pines FL33028
PhoneExtFaxE-Mail Address
(954) 985 - 1165 (954) 212 - 0178jack@pplrrg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRAMASWAMI KRISHNAN
Insurer TypeStreet Address of Practice
Licensed1000 Waterman Way
CityStateZip CodeCounty
TavaresFL32778Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
106591$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME89430Radiology - Diagnostic - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL WATERMAN100057
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
2/26/20098/9/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
This matter pertains to pregnancy ultrasounds performed on patient¿s motheron September 24, 2008 and January 26, 2009 at the Center for Medical Imaging
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The allegations are that the ultrasounds were poorly performed by the technologists and incorrectly interpreted by Dr. Krishnan.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Poorly performed ultrasounds by the technologists and incorrectly interpreted by Dr. Krishnan resulting in the failure to diagnose patient baby with congenital cystic adenoid malformation (CCAM) resulting in the need for a bilateral lung transplant after birth, date of birth February 26, 2009.
Principal Injury Giving Rise To The Claim
The allegations against Dr. Krishnan are as follows: Failure to observe and report the lung abnormalities seen on the September 24, 2008 and January 26, 2009 pregnancy ultrasounds; Failure to perform adequate or diagnostic ultrasounds on September 24, 2008 and January 26, 2009; Failure to inform patient¿s mother on September 24, 2009 that the pregnancy ultrasound was limited and/or suboptimal or that the anatomy was not sufficiently visible; Failure to repeat and/or instruct the ordering physician to repeat the September 24, 2008 pregnancy ultrasound; and Failure to describe the September 24, 2008 pregnancy ultrasound as suboptimal, normal fetal survey when the quality of the test was poor.
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
3/9/201111-CA-518
County Suit Filed inDate of Final Disposition
Lake2/11/2013
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
2/13/2013
 
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$39,117
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
N/A
 
Updates
 
No updates found.

 

 

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Dr. MARY CUNNINGHAM HOMMINGA Medical Malpractice Lawsuits - Court Case # 2009-CA-000303

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201262964
Claim Number :FEP-08-78750-MH
Date Submitted :2/28/2012
 
Insurer Information
 
Insurer NameCoverage Type
EVEREST INDEMNITY INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
22-3520347 
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
IndividualMARY CUNNINGHAM HOMMINGA
Insurer TypeStreet Address of Practice
Licensed1378 MONDON HILL ROAD
CityStateZip CodeCounty
BROOKSVILLEFL34601Hernando
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
6500000229-081$250,000$750,000
Profession or BusinessOther Profession or Business
OtherPHYSICIAN ASSISTANT
License NumberSpecialty Code & ClassificationCertification Number
ARNP2157532  

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL WATERMAN100057
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
10/28/20065/21/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
HERPETIC MENINGITIS
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
EXAMINATION IN ED
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
HEADACHE
Principal Injury Giving Rise To The Claim
PERMANENT BRAIN INJURY
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
5/4/20092009-CA-000303
County Suit Filed inDate of Final Disposition
Lake1/30/2012
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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
 
 
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$67,508
All Other Loss Adjustment Expense Paid$13,766
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. William H Weaver Medical Malpractice Lawsuits - Court Case # 13-CA-556

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201367661
Claim Number :1009237-01
Date Submitted :8/27/2013
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualSusan KSpielman
Street Address
5814 Reed Road
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0340  reportaclaim@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualWilliamHWeaver
Insurer TypeStreet Address of Practice
Licensed1936 Salk Ave
CityStateZip CodeCounty
TavaresFL32778Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
654175$250,000$750,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS5726Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MLake
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
12/28/20117/27/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest pain
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Exam, labs, EKG, stress test
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to timely diagnose and treat myocardial infarction
Principal Injury Giving Rise To The Claim
Death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/15/201313-CA-556
County Suit Filed inDate of Final Disposition
Lake6/18/2013
Other Defendants Involved in this Claim
Carefirst Family Practice
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
6/18/2013
 
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$5,288
All Other Loss Adjustment Expense Paid$713
Injured Person's Total Non-Economic Loss$125,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
 
Date of Change:8/27/2013 8:27:13 AM
Reason for Change:Update ALE
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel50435288

 

 

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Dr. Maohao Han Medical Malpractice Lawsuits - Court Case # 2011-CA-2016

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201368330
Claim Number :PLFWAT062870
Date Submitted :9/11/2013
 
Insurer Information
 
Insurer NameCoverage Type
Florida Hospital WatermanPrimary
Insurer FEINProfessional License Number
59-31406694409
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJudith AHenderson
Street Address
900 Hope Way
CityStateZip
Altamonte SpringsFL32714
PhoneExtFaxE-Mail Address
(407) 357 - 2292 (407) 975 - 1570judith.henderson@ahss.org
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMaohao Han
Insurer TypeStreet Address of Practice
Self-Insurer900 Winderley Place, Suite 1400
CityStateZip CodeCounty
MaitlandFL32751Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
8528-2011$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME94864Surgery - Abdominal 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FLake
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL WATERMAN100057
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
12/2/20084/18/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
ER visit due to abdominal pain
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failing to convert from a laparoscopic procedure to an open procedure in light of diagnosis of acute appendicitis
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Negligent care and treatment
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
8/12/20112011-CA-2016
County Suit Filed inDate of Final Disposition
Lake8/31/2012
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
8/27/2012
 
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$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
N/A
 
Updates
 
No updates found.

 

 

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

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