Medical Malpractice Cases

Medical Malpractice Cases In Osceola County Florida

Dr. Frank J Stone Medical Malpractice Lawsuits - Court Case # 2010-CA-018434

Indemnity Paid: $1,500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201263967
Claim Number :HPFPMG041644
Date Submitted :5/29/2012
 
Insurer Information
 
Insurer NameCoverage Type
Stone, Frank JPrimary
Insurer FEINProfessional License Number
00-0002009ME62459
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCharlesHEdmands
Street Address
900 Hope Way
CityStateZip
Altamonte SpringsFL32714
PhoneExtFaxE-Mail Address
(407) 357 - 2291  chuck.edmands@ahss.org
 
Insured Information
 
TypeFirst NameMILast Name
IndividualFrankJStone
Insurer TypeStreet Address of Practice
Self-Insurer410 CELEBRATION PLACE, Suite 103
CityStateZip CodeCounty
CelebrationFL34747Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
8528-2009$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME62459Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
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
Otherphysician's office
Date of OccurrenceDate Reported to Insurer
9/22/20083/25/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
hypothyroidism and bipolar disorder
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to appropriately monitor the patient's Lithium level, and recognize and treat her for lithium toxicity, which resulted in her death.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
plz see above
Principal Injury Giving Rise To The Claim
plz see above
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/30/20102010-CA-018434
County Suit Filed inDate of Final Disposition
Osceola5/21/2012
Other Defendants Involved in this Claim
Hartley, MD, Todd
Celebration Family Care
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
3/28/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,500,000
Loss Adjust Expense Paid to Defense Counsel$60,834
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
Shared all of unsupportive experts' liability & causation opinions with the assured physician
 
Updates
 
No updates found.

 

 

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Dr. Kurt R Mayberry Medical Malpractice Lawsuits - Court Case # CI-01MP2238

Indemnity Paid: $1,117,665.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200642073
Claim Number :119953
Date Submitted :8/12/2009
 
Insurer Information
 
Insurer NameCoverage Type
PROASSURANCE CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
38-2317569 
Insurer Contact Information
TypeEntity Name
EntityProAssurance Indemnity Company, Inc.
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
IndividualKurtRMayberry
Insurer TypeStreet Address of Practice
Licensed1343 MORNINGSIDE DR
CityStateZip CodeCounty
REXBURGID83440-5081Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PNFL-3003709-00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78411Emergency Medicine - No Major Surgery00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL-CELEBRATION HEALTH23960017
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
11/12/19998/1/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Abdominal pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Exam, CBC, abdominal ultrasound and abdoominal X-ray performed indicated an ovarian cyst and ileum.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Plaintiff suffered a ruptured appendix which was diagnosed ten days later.
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
12/20/2002CI-01MP2238
County Suit Filed inDate of Final Disposition
Osceola8/15/2006
Other Defendants Involved in this Claim
Cortes-Belen, Ernesto
Florida Emergency Physicians Kang & Associates, M.D., P.A.
Adventist Health System/Sunbelt, Inc. d/b/a Florida Hospital
Stage of Legal System at which Settlement was Reached or Award Made
After notice of appeal is filed or post judgment relief of action is required for recovery.
Final Method of Claim Disposition
Disposed of by Court
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/23/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,117,665
Loss Adjust Expense Paid to Defense Counsel$109,315
All Other Loss Adjustment Expense Paid$59,041
Injured Person's Total Non-Economic Loss$1,117,665
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:4/28/2008 10:25:09 AM
Reason for Change:Updated to reflect indmenity payment, as well as additional legal fees and costs paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid2456861867
Indemnity Paid01117665
Injured Person Total Non-Economic Loss01117665
Settlement Reached01
Amount of Loss Adjustment Expense Paid to Defense Counsel49157105530
Legal System StageAfter court verdict and prior to filing of notice of appeal.After notice of appeal is filed or post judgment relief of action is required for recovery.
Court DecisionJudgment for the defendant.Judgment for the plaintiff.
 
Date of Change:8/12/2009 11:20:32 AM
Reason for Change:Report updated to reflect additional legal fees paid, and reimbursement of costs.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid6186759041
Amount of Loss Adjustment Expense Paid to Defense Counsel105530109315

 

 

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Dr. Edward H Sessions Medical Malpractice Lawsuits - Court Case # 10-CA-2338-MP

Indemnity Paid: $725,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201159929
Claim Number :32224
Date Submitted :4/11/2011
 
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
IndividualEdwardHSessions
Insurer TypeStreet Address of Practice
Licensed1543 Gants Circle
CityStateZip CodeCounty
Kissimmee FL34744Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PRF 1406626 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME20408Radiology - interventional 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other LocationOsceola Imaging Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
11/1/200711/5/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Breast cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Mammogram
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose breast cancer
Principal Injury Giving Rise To The Claim
Breast cancer
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/20/201010-CA-2338-MP
County Suit Filed inDate of Final Disposition
Osceola4/7/2011
Other Defendants Involved in this Claim
Osceola Radiology Associates, 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
2/10/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$725,000
Loss Adjust Expense Paid to Defense Counsel$54,158
All Other Loss Adjustment Expense Paid$27,078
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$36,845$0
Wage Loss$0$0
Other Expenses$20,059$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:4/11/2011 10:11:16 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 04/07/2011
 
Field ChangedFormer ValueNew Value
Date of Final Disposition10-FEB-1107-APR-11

 

 

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Dr. Nhan T Pham Medical Malpractice Lawsuits - Court Case # 2013-CA-001935-MP

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201367835
Claim Number :298776
Date Submitted :7/30/2013
 
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
IndividualNhanTPham
Insurer TypeStreet Address of Practice
Licensed2901 Parkway Blvd., Suite B-2
CityStateZip CodeCounty
KissimmeeFL34747Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0352520$500,000$1,500,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS10112Surgery - Plastic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilitySurgical Center
Name of InstitutionCode
UNDERWOOD SURGERY CENTER205
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
7/13/20128/31/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Permanent scarring, appendix removal.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient underwent abominoplasty and liposuction perfomed by the insured,
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Alleged perforation of the patient's secum during abdominoplasty with liposuction.
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
5/15/20132013-CA-001935-MP
County Suit Filed inDate of Final Disposition
Osceola7/25/2013
Other Defendants Involved in this Claim
Nhan T. Pham, D.O., PLLC
Stage of Legal System at which Settlement was Reached or Award Made
Within 90 days of suit being filed.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/19/2013
 
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$15,400
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$401,353
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$98,647$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. Mamta Vijayvargiya Medical Malpractice Lawsuits - Court Case # C105-MP2718

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200639338
Claim Number :244993
Date Submitted :1/30/2006
 
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
13450 West Sunrise Blvd., Suite 160
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(954) 858 - 0202 (954) 838 - 7480JMaldonado@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMamta Vijayvargiya
Insurer TypeStreet Address of Practice
Licensed737 West Oak Street
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
67876$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME83720Hematology - No Surgery 

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
OtherPhysician's Office
Date of OccurrenceDate Reported to Insurer
3/26/20049/20/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Breast lump.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Delay in providing timely and appropriate medical treatment for bilateral breast cancer treatment.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Delay in providing timely and appropriate medical treatment.
Principal Injury Giving Rise To The Claim
Diminished life expectancy due to a delay in providing timely and appropriate medical treatment for bilateral breast cancer.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/15/2005C105-MP2718
County Suit Filed inDate of Final Disposition
Osceola1/25/2006
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
1/19/2006
 
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$13,000
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$350,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$150,000$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.

 

 

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Dr. PRESTON B WHITE Medical Malpractice Lawsuits - Court Case # CA004082MP

Indemnity Paid: $425,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201369169
Claim Number :C147112
Date Submitted :12/12/2013
 
Insurer Information
 
Insurer NameCoverage Type
ADMIRAL INSURANCE COMPANY Primary
Insurer FEINProfessional License Number
22-2235730 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDianeMPucci
Street Address
1000 Howard Boulevard
CityStateZip
Mt. LaurelNJ08054
PhoneExtFaxE-Mail Address
(856) 857 - 3375 (856) 429 - 3630dpucci@admiralins.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPRESTONBWHITE
Insurer TypeStreet Address of Practice
Licensed1319 E. OSCEOLA PARKWAY, SUITE C
CityStateZip CodeCounty
KISSIMMEEFL34744Seminole
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
EO000011023-03 $1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Dentistry 
License NumberSpecialty Code & ClassificationCertification Number
DN10854Dentists 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
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
5/19/20115/20/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
EXTRACTION OF ALL UPPER AND LOWER TEETH AND PROVIDE FULLUPPER AND LOWER DENTURES.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
INSURED ADMINISTERED NITROUS OXIDE AND APPROXIMATELY 12CARPS OF CARBOCAINE AND 3% MEPIFICAINE WHICH WAS THELOCAL ANESTHETIC. THE PATIENT STATED SHE FELT LIGHTHEADED AND WAS FEELING SICK. SHE STARTED TO VOMIT ANDFOAM STARTED COMING OUT OF HER NOSE. SHE COLLAPSED ONTOTHE FLOOR AND THE INSURED CALLED 911. THE PATIENTWEIGHTED 250-300 LBS AND COULD NOT BE EASILY MOVED.WHEN THE PARAMEDICS ARRIVED THE PATIENT WAS STILLBREATHING BUT THEY HAD A DIFFICULT TIME LIFTING HER ONTOTHE GURNEY TO TRANSFER HER TO THE AMBULANCE. THEYSTARTED CRP IN THE BACK OF THE AMBULANCE ON THE WAY TOTHE HOSPITAL. THE INSURED RECEIVED A CALL APPROXIMATELY45 MINUTES LATER THAT THE PATIENT HAD PASSED AWAY.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAILURE TO TAKE A COMPREHENSIVE MEDICAL HISTORYINCLUDING AN ASA SEDATION PROFILE BEFORE ADMINISERINGANESTHESIA. OVERDOSE OF CARBOCAINE IN COMBINATION WITHTHE USE OF VALIUM AND NITROUS OXIDE AND FAILURE TOPERFORM CPR OR OTHER RESUSCITATION WHILE PATIENT WAS INTHE INSURED'S OFFICE.
Principal Injury Giving Rise To The Claim
PATIENT DIED
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/3/2012CA004082MP
County Suit Filed inDate of Final Disposition
Osceola9/18/2013
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
10/21/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$425,000
Loss Adjust Expense Paid to Defense Counsel$54,215
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
NONE
 
Updates
 
No updates found.

 

 

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Dr. Susan M Rendon Medical Malpractice Lawsuits - Court Case # 2009-CA-007513 MP

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201057246
Claim Number :29725
Date Submitted :8/13/2010
 
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
IndividualSusanMRendon
Insurer TypeStreet Address of Practice
Licensed913 E. North Blvd.
CityStateZip CodeCounty
LeesburgFL34748Lake
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 0105304 09$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME62396Pharmacology - Clinical 

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
Other Outpatient FacilityPathology Lab
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
OtherPathology Lab
Date of OccurrenceDate Reported to Insurer
10/27/20063/2/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Stomach cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Read pathology slides
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose cancer
Principal Injury Giving Rise To The Claim
Stomach cancer resulting in death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/7/20092009-CA-007513 MP
County Suit Filed inDate of Final Disposition
Osceola8/10/2010
Other Defendants Involved in this Claim
Pathology Medical Laboratories, 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
4/29/2010
 
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$31,904
All Other Loss Adjustment Expense Paid$11,954
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$135,000$0
Wage Loss$39,869$0
Other Expenses$15,521$519,902
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:8/13/2010 11:00:42 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 08/10/10
 
Field ChangedFormer ValueNew Value
Date of Final Disposition29-APR-1010-AUG-10

 

 

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Dr. Ghazala T Mumtaz Medical Malpractice Lawsuits - Court Case # 2010-CA-007222 MP

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264526
Claim Number :290932
Date Submitted :8/10/2012
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualAngela LaFrance
Street Address
13450 W. Sunrise Blvd., Suite 160
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(954) 838 - 9988 (866) 636 - 5421alafrance@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGhazalaTMumtaz
Insurer TypeStreet Address of Practice
Licensed724 W. Vine Street
CityStateZip CodeCounty
KissimmeeFL34741Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
70377$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME93344Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL - KISSIMMEE100089
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
4/27/200911/14/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Shortness of breath, difficulty breathing and chest tightness.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient was admitted to the hospital with a working diagnosis of pneumonia.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
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
2/17/20122010-CA-007222 MP
County Suit Filed inDate of Final Disposition
Osceola7/30/2012
Other Defendants Involved in this Claim
Mumtaz, MD, Syed T
Syed Tariq Mumtaz, MD, PA
Adventist Hospital/Sunbelt Inc dba Florida Hospital Kissimme
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
7/26/2012
 
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$30,000
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$235,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$15,000$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. Syed Mumtaz Medical Malpractice Lawsuits - Court Case # 2010CA007222

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264571
Claim Number :59161001
Date Submitted :8/17/2012
 
Insurer Information
 
Insurer NameCoverage Type
PHYSICIANS INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
13-4235490 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualBecky Sanders
Street Address
361 E. Hillsboro Blvd.
CityStateZip
Deerfield BeachFL33441
PhoneExtFaxE-Mail Address
(954) 788 - 5610 (954) 788 - 5367bsanders@picinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualSyed Mumtaz
Insurer TypeStreet Address of Practice
Licensed403 West Oak Street
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
132082$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME70936Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL - KISSIMMEE100089
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
5/1/200910/15/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient was admitted to the hospital with complaints of shortness of breath.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient was admitted and treated for pneumonia and an interstitial infection.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose and treat pulmonary embolism.
Principal Injury Giving Rise To The Claim
Patient developed a pulmonary embolism while in the hospital and died.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/28/20102010CA007222
County Suit Filed inDate of Final Disposition
Osceola7/19/2012
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$250,000
Loss Adjust Expense Paid to Defense Counsel$26,359
All Other Loss Adjustment Expense Paid$22,774
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
n/a
 
Updates
 
No updates found.

 

 

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Dr. Michael A Karr Medical Malpractice Lawsuits - Court Case # 11-CA-361 MP

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264883
Claim Number :5144654-01
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
IndividualSusan KSpielman
Street Address
5814 Reed Road
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(260) 486 - 0340  reportaclaim@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMichaelAKarr
Insurer TypeStreet Address of Practice
Licensed604 Oak Commons Blvd
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
604878$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME45532Surgery - Orthopedic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
OSCEOLA REGIONAL HOSPITAL100110
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
9/29/20098/16/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Left knee pain
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Total knee replacement
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Improper treatment
Principal Injury Giving Rise To The Claim
Permanent injury to left leg
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
2/4/201111-CA-361 MP
County Suit Filed inDate of Final Disposition
Osceola9/12/2012
Other Defendants Involved in this Claim
George MD, Kristopher
Campbell MD, Matthew
Acosta PA-C, Craig
Cardiac Surgical Associates
Noda MD, Francisco
Orthopedic Associates of Osceola
Hannum DO, Scott
The Vascular Clinic & Cosmetic Vein Treatment Ctr
Osceola Regional Hosp Inc dba Osceola Regional Med Ctr
Stage of Legal System at which Settlement was Reached or Award Made
During trial, but before court verdict.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/7/2012
 
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$23,071
All Other Loss Adjustment Expense Paid$7,735
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:2/15/2013 1:28:54 PM
Reason for Change:Update ALE
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid75537706
Amount of Loss Adjustment Expense Paid to Defense Counsel2140522429
 
Date of Change:9/23/2013 3:16:32 PM
Reason for Change:Update ALE
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid77067735
Amount of Loss Adjustment Expense Paid to Defense Counsel2242923071

 

 

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Dr. Antonio J Ramirez Medical Malpractice Lawsuits - Court Case # CI-05-MP-1671

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200639468
Claim Number :22003
Date Submitted :2/8/2006
 
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
IndividualAntonioJRamirez
Insurer TypeStreet Address of Practice
Licensed812 West Oak Street
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601398 00$250,000$750,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS6118Physicians or Surgeons - major surgery.NOC classification.1175

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
OSCEOLA REGIONAL HOSPITAL100110
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
6/15/20035/3/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Epigastric pain and vomiting three days post-op cyst removal surgery
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Exploratory laparotomy, partial small bowel resection, and repair of left inguinal internal hernia
Diagnostic Code :537.3
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely diagnose and treat small bowel obstruction
Principal Injury Giving Rise To The Claim
Abdominal sepsis
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/8/2005CI-05-MP-1671
County Suit Filed inDate of Final Disposition
Osceola1/6/2006
Other Defendants Involved in this Claim
Osceola Regional Hospital
Lester, M.D., Donna S
Family Practice Assoc., 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
1/27/2006
 
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$21,649
All Other Loss Adjustment Expense Paid$5,966
Injured Person's Total Non-Economic Loss$250,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$283,805$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. Jorge G Otoya Medical Malpractice Lawsuits - Court Case # C103MP00075

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200432762
Claim Number :225599
Date Submitted :9/10/2004
 
Insurer Information
 
Insurer NameCoverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE)Primary
Insurer FEINProfessional License Number
95-3014772 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJanet Blankenship
Street Address
13450 West Sunrise Boulevard, Suite 160
CityStateZip
SunriseFL33323
PhoneExtFaxE-Mail Address
(954) 858 - 0213 (954) 838 - 7480jblankenship@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJorgeGOtoya
Insurer TypeStreet Address of Practice
Licensed1300 West Oak Street
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
58107$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60086Hematology - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
OSCEOLA REGIONAL HOSPITAL100110
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
4/26/200112/2/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Septic shock and DIC.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in Heparin administration.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Amputation of legs and digits.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/28/2003C103MP00075
County Suit Filed inDate of Final Disposition
Osceola8/26/2004
Other Defendants Involved in this Claim
Byerly, M.D., Kenneth
Weinberger, M.D., Joel
Ryan, M.D., James
Ramirez, D.O., Maurice
Osceola 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
Directed verdict for plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
8/26/2004
 
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$53,500
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Unknown
 
Updates
 
No updates found.

 

 

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

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Dr. Wade W Han Medical Malpractice Lawsuits - Court Case # C106MP1349

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200745329
Claim Number :33843-01
Date Submitted :4/19/2007
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCheriMMontague
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualWadeWHan
Insurer TypeStreet Address of Practice
Licensed201 Hilda Street, Ste 32
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
26644$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME75769Surgery - Otorhinolaryngology80159

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL - KISSIMMEE100089
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
11/10/20043/8/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Biopsy for laryngeal mass, which revealed moderately differentiated squamous cell carcinoma.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Following extubation, the patient had subsequent respiratory complications and hypoxia occurred during the reintubation and emergency tracheotomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
As the patient had a prior CVA, the pre-existing brain damage and hypoxia during the reintubation-emergency tracheotomy, resulted in a catastrophic brain injury.The patient remained in a coma and expired one year later.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/5/2006C106MP1349
County Suit Filed inDate of Final Disposition
Osceola3/20/2007
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
3/20/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$14,739
All Other Loss Adjustment Expense Paid$11,650
Injured Person's Total Non-Economic Loss$250,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$284,000$0
Wage Loss$0$0
Other Expenses$7,000$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. VICKI FRIEND Medical Malpractice Lawsuits - Court Case # CI 06 ON445

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746556
Claim Number :FEP-05-39856
Date Submitted :8/13/2007
 
Insurer Information
 
Insurer NameCoverage Type
EVEREST INDEMNITY INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
22-3520347 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancyJThomas
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualVICKI FRIEND
Insurer TypeStreet Address of Practice
Licensed1051 Winderley Place, Suite 103
CityStateZip CodeCounty
MAITLANDFL32751Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
4700000006-051$250,000$750,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS7562Emergency Medicine - No Major Surgery 

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
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL (ORLANDO)100007
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/29/20049/27/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
CARDIAC PROBLEMS
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ALLEGED DELAY IN TX CARDIAC PROBLEMS
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
DELAY IN TREATMENT
Principal Injury Giving Rise To The Claim
CARDIAC ARREST, DEATH
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/1/2006CI 06 ON445
County Suit Filed inDate of Final Disposition
Osceola8/10/2007
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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
6/12/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$92,554
All Other Loss Adjustment Expense Paid$17,565
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. VIDOR E FRIEDMAN Medical Malpractice Lawsuits - Court Case # 04MP001657

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746605
Claim Number :FEP-04-32381
Date Submitted :8/16/2007
 
Insurer Information
 
Insurer NameCoverage Type
EVEREST INDEMNITY INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
22-3520347 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancyJThomas
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualVIDOREFRIEDMAN
Insurer TypeStreet Address of Practice
Licensed1051 WINDERLEY PLACESUITE 103
CityStateZip CodeCounty
MAITLANDFL32751Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
4700000006-041$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME72697Emergency Medicine - No Major Surgery 

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
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL-CELEBRATION HEALTH23960017
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
8/17/20032/20/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
CORONARY INSUFFICIENCY
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ALLEGED FAILURE TO DIAGNOSE AND TREAT
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAILURE TO DIAGNOSE
Principal Injury Giving Rise To The Claim
DEATH DUE TO CORONARY ARTERY DISSECTION
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/5/200404MP001657
County Suit Filed inDate of Final Disposition
Osceola8/15/2007
Other Defendants Involved in this Claim
FLORIDA EMERGENCY PHYSICIANS
FLORIDA HOSPITAL CELEBRATION
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
4/9/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$78,295
All Other Loss Adjustment Expense Paid$30,220
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. Bruce Blackwell Medical Malpractice Lawsuits - Court Case # CI06MP1597

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746726
Claim Number :33845-01
Date Submitted :8/28/2007
 
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
IndividualBruce Blackwell
Insurer TypeStreet Address of Practice
Licensed200 Park Place
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
99323$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME57535Family Physicians or General Practitioners - No Surgery80239

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
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
11/2/19983/8/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
General medical care.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
None.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Alleged failure to perform colorectal cancer screening.The patient was subsequently diagnosed with colon cancer and has a permanent colostomy.
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
7/24/2006CI06MP1597
County Suit Filed inDate of Final Disposition
Osceola8/3/2007
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
8/3/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$13,001
All Other Loss Adjustment Expense Paid$12,353
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. Luis J Sanchez-Robles Medical Malpractice Lawsuits - Court Case # CI-04-MP1913

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200850558
Claim Number :6283-01
Date Submitted :8/20/2008
 
Insurer Information
 
Insurer NameCoverage Type
PODIATRY INSURANCE COMPANY OF AMERICAPrimary
Insurer FEINProfessional License Number
58-1403235 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKaren Kessler
Street Address
110 Westwood Place
CityStateZip
BrentwoodTN37027
PhoneExtFaxE-Mail Address
(615) 371 - 87762249 kkessler@picagroup.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualLuisJSanchez-Robles
Insurer TypeStreet Address of Practice
Licensed819 E OAK ST
CityStateZip CodeCounty
KISSIMMEEFL34744-5842Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
1-6358$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Podiatric Physician 
License NumberSpecialty Code & ClassificationCertification Number
PO2179  

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
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
3/29/20024/20/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pain, plantar aspect of right heel
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Steroid injections
Diagnostic Code :726.73
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient developed infection that subsequently led to BKA.Patient alleges improper treatment and failure to diagnose
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
8/25/2004CI-04-MP1913
County Suit Filed inDate of Final Disposition
Osceola8/21/2007
Other Defendants Involved in this Claim
Orlando Foot & Ankle Clinic, 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
8/23/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$57,768
All Other Loss Adjustment Expense Paid$4,662
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
None - Specialty Code #80993
 
Updates
 
No updates found.

 

 

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

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Dr. Maria-Isabel Zapata Medical Malpractice Lawsuits - Court Case # 2007-CA-005558

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200851148
Claim Number :33315-01
Date Submitted :10/16/2008
 
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
IndividualMaria-Isabel Zapata
Insurer TypeStreet Address of Practice
Licensed200 Park Place
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
99323$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME93748Family Physicians or General Practitioners - No Surgery80239

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
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
10/14/200510/31/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Dyspnea on exertion, chest pain, anorexia and vomiting.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to determine signs and symptoms of pulmonary embolism.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Death from pulmonary embolism.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/5/20072007-CA-005558
County Suit Filed inDate of Final Disposition
Osceola9/22/2008
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
9/22/2008
 
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$52,090
All Other Loss Adjustment Expense Paid$32,843
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$167,258$632,099
Other Expenses$0$440,514
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. Mario R Sobrino Medical Malpractice Lawsuits - Court Case # 49-2007-CI-001964

Indemnity Paid: $245,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200848290
Claim Number :143826
Date Submitted :8/20/2009
 
Insurer Information
 
Insurer NameCoverage Type
PROASSURANCE CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
38-2317569 
Insurer Contact Information
TypeEntity Name
EntityProAssurance Indemnity Company, Inc.
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
IndividualMarioRSobrino
Insurer TypeStreet Address of Practice
Licensed911 North Central Avenue
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP36569$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME62520Family Physicians or General Practitioners - No Surgery00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
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
5/23/20055/10/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Detached retina.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to refer to opthamologist.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Loss of sight.
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
6/15/200749-2007-CI-001964
County Suit Filed inDate of Final Disposition
Osceola12/21/2007
Other Defendants Involved in this Claim
Fontanez, Marizol
Medical and Geriatric Associates, 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
1/10/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$245,000
Loss Adjust Expense Paid to Defense Counsel$26,194
All Other Loss Adjustment Expense Paid$3,736
Injured Person's Total Non-Economic Loss$245,000
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 has discussed case with insurance company personnel, medical experts and defense counsel.
 
Updates
 
 
Date of Change:8/20/2009 10:55:01 AM
Reason for Change:Report updated to reflect additional legal fees and expenses paid.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel1892326194
All Other Loss Adjustment Expense Paid19643736

 

 

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Dr. Rafael Jimenez Medical Malpractice Lawsuits - Court Case # CI-07-MP4711

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200851836
Claim Number :25752
Date Submitted :12/19/2008
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRafael Jimenez
Insurer TypeStreet Address of Practice
LicensedPO Box 423549
CityStateZip CodeCounty
KissimmeeFL34742Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600622 05$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME59612Cardiovascular Disease - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
OSCEOLA REGIONAL HOSPITAL100110
Location of Institutional InjuryOther Location of Institutional Injury
Special Procedure Room 
Date of OccurrenceDate Reported to Insurer
5/10/20056/18/2007
 
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
Stress test
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to conduct complete stress test and diagnose coronary artery disease
Principal Injury Giving Rise To The Claim
Atherosclerotic coronary artery disease
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/23/2007CI-07-MP4711
County Suit Filed inDate of Final Disposition
Osceola12/15/2008
Other Defendants Involved in this Claim
PriMed Healthcare, PA
Stage of Legal System at which Settlement was Reached or Award Made
Within 90 days of suit being filed.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/16/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$225,000
Loss Adjust Expense Paid to Defense Counsel$29,104
All Other Loss Adjustment Expense Paid$12,464
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:12/19/2008 3:30:26 PM
Reason for Change:Report updated to reflect correct Loss Adjusted/Counsel amount of $29,104
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel291429104

 

 

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Dr. Esteban L Janolo Medical Malpractice Lawsuits - Court Case # CI-04MP-2660

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537015
Claim Number :A04-31346-04
Date Submitted :10/5/2005
 
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 Drive, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualEstebanLJanolo
Insurer TypeStreet Address of Practice
Licensed203 Westmoreland Circle
CityStateZip CodeCounty
KissimmeeFL34744Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
44607$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME67483Internal Medicine - No Surgery80257

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
OSCEOLA REGIONAL HOSPITAL100110
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
2/16/20049/13/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to hospital with acute appendicitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient underwent emergency laparoscopic appendectomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Patient suffered an undiagnosed post-operative ileus.
Principal Injury Giving Rise To The Claim
Patient was discharged from hospital and was found dead in her home 3 days post discharge.Autopsy indicated ileus which caused fatal arrhythmia.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/26/2004CI-04MP-2660
County Suit Filed inDate of Final Disposition
Osceola9/14/2005
Other Defendants Involved in this Claim
Ramirez, D.O., Antonio J
Antonio Ramirez, D.O., P.A.
Osceola Internal Medicine, 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
9/14/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$225,000
Loss Adjust Expense Paid to Defense Counsel$4,585
All Other Loss Adjustment Expense Paid$1,823
Injured Person's Total Non-Economic Loss$225,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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Dr. Fenton E Froom Medical Malpractice Lawsuits - Court Case # 2009-CA-011089ON

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201058069
Claim Number :30751
Date Submitted :10/12/2010
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMG 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
IndividualFentonEFroom
Insurer TypeStreet Address of Practice
Licensed9007 Shawn Park Place
CityStateZip CodeCounty
OrlandoFL32819Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600217 09$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME36200Radiology - Diagnostic - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityKissimmee Outpatient Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
3/20/20076/11/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Annual mammogram
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Mammogram
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose breast cancer
Principal Injury Giving Rise To The Claim
Breast cancer
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
11/30/20092009-CA-011089ON
County Suit Filed inDate of Final Disposition
Osceola8/31/2010
Other Defendants Involved in this Claim
Bias, ARNP, Barbara
Kissimmee Outpatient Center
Casella, MD, Peter J
Cook, ARNP, Pamela
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
7/21/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$225,000
Loss Adjust Expense Paid to Defense Counsel$19,052
All Other Loss Adjustment Expense Paid$6,137
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$7,500$0
Wage Loss$5,000$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:10/12/2010 4:33:59 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 08/31/10
 
Field ChangedFormer ValueNew Value
Date of Final Disposition21-JUL-1031-AUG-10

 

 

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Dr. David Marcantel Medical Malpractice Lawsuits - Court Case # 48-2008-CA 032176-0

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200954528
Claim Number :37489-01
Date Submitted :8/10/2009
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualDavid Marcantel
Insurer TypeStreet Address of Practice
LicensedP. O. Box 470056
CityStateZip CodeCounty
CelebrationFL34747Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
18790$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME68062Surgery - Obstetrics - Gynecology80153

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL-CELEBRATION HEALTH23960017
Location of Institutional InjuryOther Location of Institutional Injury
Labor and Delivery Room 
Date of OccurrenceDate Reported to Insurer
6/15/20077/31/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient suffered brachial plexus injury.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Vaginal delivery.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Brachial plexus 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
12/18/200848-2008-CA 032176-0
County Suit Filed inDate of Final Disposition
Osceola7/14/2009
Other Defendants Involved in this Claim
Florida Hospital Celebration
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
7/14/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$225,000
Loss Adjust Expense Paid to Defense Counsel$12,962
All Other Loss Adjustment Expense Paid$10,110
Injured Person's Total Non-Economic Loss$225,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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Dr. Ajaz Afzal Medical Malpractice Lawsuits - Court Case # 2014-CA-000058 MP

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201471647
Claim Number :30268-1
Date Submitted :8/20/2014
 
Insurer Information
 
Insurer NameCoverage Type
LANCET INDEMNITY RISK RETENTION GROUP INC.Primary
Insurer FEINProfessional License Number
26-1479165 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualChristopher  Teter
Street Address
2810 West St. Isabel Street Suite 100
CityStateZip
TampaFL33602
PhoneExtFaxE-Mail Address
(813) 290 - 8282265 cteter@lancetindemnity.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAjaz Afzal
Insurer TypeStreet Address of Practice
Licensed1016 Mann Street
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
LR091212001488$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME95168Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
OSCEOLA REGIONAL HOSPITAL100110
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
7/11/201211/13/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient sought treatment for appendicitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Delay in diagnosing and treating appendicitis.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to timely diagnose and treat appendicitis.
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
1/8/20142014-CA-000058 MP
County Suit Filed inDate of Final Disposition
Osceola3/20/2014
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
Within 90 days of suit being filed.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
3/20/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$225,000
Loss Adjust Expense Paid to Defense Counsel$39,476
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$225,000$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurer is unaware of any steps taken at this time.
 
Updates
 
No updates found.

 

 

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Dr. Mohammad H Qazi Medical Malpractice Lawsuits - Court Case # CI00MP0380

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537322
Claim Number :12179
Date Submitted :10/13/2005
 
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
IndividualMohammadHQazi
Insurer TypeStreet Address of Practice
Licensed631 Palm Springs Drive, Suite 111
CityStateZip CodeCounty
Altamonte SpringsFL32701Seminole
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 0103694 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME56502Radiology - Diagnostic - Minor Surgery70401

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOsceola
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FLORIDA HOSPITAL - KISSIMMEE100089
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
5/14/199611/11/1999
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Congenital hip dysplasia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :808.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose congenital hip dysplasia
Principal Injury Giving Rise To The Claim
Multiple surgical intervention and arthritis of hips
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
3/3/2000CI00MP0380
County Suit Filed inDate of Final Disposition
Osceola12/22/2004
Other Defendants Involved in this Claim
Karr, MD, Michael
Stage of Legal System at which Settlement was Reached or Award Made
After appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Judgment for the plaintiff after appeal ... 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/22/2004
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$200,000
Loss Adjust Expense Paid to Defense Counsel$140,766
All Other Loss Adjustment Expense Paid$35,191
Injured Person's Total Non-Economic Loss$200,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$85,000$250,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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