Medical Malpractice Cases

Medical Malpractice Cases In Putnam County Florida

Dr. Frank Imas Medical Malpractice Lawsuits - Court Case # 2015CA-000499

Indemnity Paid: $400,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201679367
Claim Number : 331485
Date Submitted : 8/5/2016
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Frank   Imas
Insurer Type Street Address of Practice
Licensed 951 North Washington Avenue
City State Zip Code County
Titusville FL 32796 Brevard
Policy Number Per Claim Policy Limits Aggregate Policy Limits
981460 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME81981 Anesthesiology  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
PUTNAM COMMUNITY MEDICAL CENTER 100232
Location of Institutional Injury Other Location of Institutional Injury
Recovery Room  
Date of Occurrence Date Reported to Insurer
1/6/2015 6/30/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented to the ER with complaints of abdominal pain. The patient is deceased.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient underwent a laparoscopic repair of incarcerated central hernia. The insured provided anesthesia support.
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.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
12/9/2015 2015CA-000499
County Suit Filed in Date of Final Disposition
Putnam 7/7/2016
Other Defendants Involved in this Claim
Caudill, DO, Jeremy
Edwards, ARNP, Willie
Putnam Community 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 Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/7/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $400,000
Loss Adjust Expense Paid to Defense Counsel $29,211
All Other Loss Adjustment Expense Paid $3,435
Injured Person's Total Non-Economic Loss $400,000
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. Frank Imas Medical Malpractice Lawsuits - Court Case # 542015CA000499CAAXMX

Indemnity Paid: $400,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201679442
Claim Number : 0331485
Date Submitted : 8/17/2016
 
Insurer Information
 
Insurer Name Coverage Type
THE DOCTORS COMPANY RISK RETENTION GROUP, A RECIPROCAL EXCHANGE Excess
Insurer FEIN Professional License Number
80-0787558  
Insurer Contact Information
Type First Name MI Last Name
Individual Frank   Imas
Street Address
230 Sheridan Ave.
City State Zip
Satellite Beach FL 32937
Phone Ext Fax E-Mail Address
(321) 961 - 5280     fimas1@gmail.com
 
Insured Information
 
Type First Name MI Last Name
Individual Frank   Imas
Insurer Type Street Address of Practice
Licensed 611 Zeagler Dr
City State Zip Code County
Palatka FL 32177 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0981460 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME81981 Anesthesiology  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
PUTNAM COMMUNITY MEDICAL CENTER 100232
Location of Institutional Injury Other Location of Institutional Injury
Critical Care Unit  
Date of Occurrence Date Reported to Insurer
1/6/2015 6/5/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Incarcerated ventral hernia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Anesthesia provided for the repair of incarcerated ventral hernia. Patient developed respiratory insufficiency post operatively
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was no misdiagnosis in this case
Principal Injury Giving Rise To The Claim
While in the post anesthesia care unit patient developed respiratory insufficiency which was initially conservatively managed with BiPap device. After blood gas testing showed mixed acidosis the decision was made to intubate and place the pt on the ventilator overnight. Patient was transferred to ICU with monitors and intubated on arrival. Tracheal intubation was uneventful. within 5-10 post intubation patient developed cardiac arrest. ACLS protocol was immediately initiated but was not successful. Patient was pronounced dead. Plaintiff alleged the death was caused by rushing to surgery and failure to treat respiratory insufficiency
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
6/24/2015 542015CA000499CAAXMX
County Suit Filed in Date of Final Disposition
Putnam 12/4/2015
Other Defendants Involved in this Claim
Caudill, Jeremy
Edwards, Willie
Putnam Community 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 Decision Other
No Court Proceedings.  
Arbitration
Award for plaintiff.
Date of Payment
7/19/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $400,000
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 Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
There were no safety issues related to the event. The death was caused by a catastrophic event not directly related to patient condition management which was difficult to prove due to event's close time proximity to the last management intervention and lack of an autopsy
 
Updates
 
No updates found.

 

 

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Dr. Kaushalendra Singh Medical Malpractice Lawsuits - Court Case # 17 CA 295

Indemnity Paid: $250,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201884985
Claim Number : 59275701
Date Submitted : 4/10/2018
 
Insurer Information
 
Insurer Name Coverage Type
PHYSICIANS INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
13-4235490  
Insurer Contact Information
Type First Name MI Last Name
Individual John D King
Street Address
901 south mopac Blvd V ste 400
City State Zip
Austin TX 78746
Phone Ext Fax E-Mail Address
(512) 425 - 5940   (512) 328 - 8067 john-king@tmlt.org
 
Insured Information
 
Type First Name MI Last Name
Individual Kaushalendra   Singh
Insurer Type Street Address of Practice
Licensed 320 Zeagler Drive Ste C
City State Zip Code County
Palatka FL 32177 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
144999 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME54534 Internal Medicine - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Physician's Office  
Name of Institution Code
PUTNAM COMMUNITY MEDICAL CENTER 100232
Location of Institutional Injury Other Location of Institutional Injury
Critical Care Unit  
Date of Occurrence Date Reported to Insurer
4/9/2016 4/6/2017
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient was admitted to the emergency room by another physician on April 9, 2016. Reporting physician became involved with patient the following morning. Patient presented with bilateral pneumonia and treatment intervention were initiated. Patient was eventually diagnosed with H1NI (swine flu).
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Despite treatment, patient's condition worsened as his oxygen saturation dropped and patient was transferred to ICU. Patient was eventually transferred to another facility for higher level care. Patient's condition deteriorated where he required intubation. Patient eventually died on May 11, 2016.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
It was alleged that defendants including reporting physicians delay with the diagnosing of H1N1 which in turn delay patient from getting appropriate treatment which would have included antiviral treatment.
Principal Injury Giving Rise To The Claim
Patient was eventually diagnosed with H1N1 which carries a poor prognosis. We believed the natural progression of the illness contributed to the outcome.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
8/1/2017 17 CA 295
County Suit Filed in Date of Final Disposition
Putnam 4/2/2018
Other Defendants Involved in this Claim
Limeres, Miguel M
Putnam Community 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 Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
3/1/2018
 
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 $39,433
All Other Loss Adjustment Expense Paid $8,420
Injured Person's Total Non-Economic Loss $250,000
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
none
 
Updates
 
No updates found.

 

 

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Dr. Miguel M Limeres Medical Malpractice Lawsuits - Court Case # 17CA295

Indemnity Paid: $235,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201884795
Claim Number : 354666
Date Submitted : 3/23/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Miguel M Limeres
Insurer Type Street Address of Practice
Licensed 530 Zeagler Drive Suite 102
City State Zip Code County
Palatka FL 32177 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0912462 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME76533 Internal Medicine - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
PUTNAM COMMUNITY MEDICAL CENTER 100232
Location of Institutional Injury Other Location of Institutional Injury
Critical Care Unit  
Date of Occurrence Date Reported to Insurer
4/14/2016 4/10/2017
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Influenza.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient developed ARDS requiring intubation and pulmonary support.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
58 year old married man developed ARDS secondary to Influenza requiring respiratory support. He was transferred to Mayo where he later died.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
3/28/2017 17CA295
County Suit Filed in Date of Final Disposition
Putnam 3/2/2018
Other Defendants Involved in this Claim
Putnam Community Medical Center of North Florida, LLC
Singh, MD, Kaushalendra
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 Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
3/2/2018
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $235,000
Loss Adjust Expense Paid to Defense Counsel $18,284
All Other Loss Adjustment Expense Paid $6,467
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $11,000 $0
Wage Loss $500,000 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. Lucien-Maximin Tchuisse Medical Malpractice Lawsuits - Court Case # 06-528-CA

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200747677
Claim Number :34234-01
Date Submitted :11/16/2007
 
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
IndividualLucien-Maximin Tchuisse
Insurer TypeStreet Address of Practice
Licensed6061 St. Johns Avenue, Ste A
CityStateZip CodeCounty
PalatkaFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
68103$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85684Surgery - Obstetrics - Gynecology80153

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
3/3/20056/2/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient underwent an exploratory laparoscopy for possible endometriosis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Perforation of the bowel during the laparoscopic procedure.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Patient suffered severe abdominal scarring from an exploratory laparotomy to repair bowel perforation.Patient had a temporary colostomy as well.
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
10/27/200606-528-CA
County Suit Filed inDate of Final Disposition
Putnam10/26/2007
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/26/2007
 
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$17,300
All Other Loss Adjustment Expense Paid$13,060
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. LAWRENCE FRIEDES Medical Malpractice Lawsuits - Court Case # 08 553 ca 53

Indemnity Paid: $225,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200954225
Claim Number :SGI-06-73574
Date Submitted :7/7/2009
 
Insurer Information
 
Insurer NameCoverage Type
CITADEL INSURANCE, RISK RETENTION GROUPPrimary
Insurer FEINProfessional License Number
20-8474742 
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
IndividualLAWRENCE FRIEDES
Insurer TypeStreet Address of Practice
Licensed129 Marshall Creek Drive
CityStateZip CodeCounty
Saint AugustineFL32095St. Johns
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
CMI AE 0801 046$1,000,000$24,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME81197Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
1/20/200611/15/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Dehydration
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to timely treat
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis
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
9/9/200808 553 ca 53
County Suit Filed inDate of Final Disposition
Putnam7/6/2009
Other Defendants Involved in this Claim
Yatco, M.D., Josephine
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
6/3/2009
 
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$24,843
All Other Loss Adjustment Expense Paid$2,533
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. Robert L Thomas Medical Malpractice Lawsuits - Court Case # 54-2011-CA-23

Indemnity Paid: $210,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201264995
Claim Number :FL-JEC-02
Date Submitted :10/4/2012
 
Insurer Information
 
Insurer NameCoverage Type
APPLIED MEDICO-LEGAL SOLUTIONS RISK RETENTION GROUP, INC.Primary
Insurer FEINProfessional License Number
81-0603029 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJulie Montague
Street Address
12700 Park Central Drive, Suite 900
CityStateZip
DallasTX75251
PhoneExtFaxE-Mail Address
(866) 520 - 6896  jmontague@bpmp.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertLThomas
Insurer TypeStreet Address of Practice
Licensed4311 North Salisbury Road
CityStateZip CodeCounty
JacksonvilleFL32216Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
G-AMS-115975$500,000$1,500,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS8592Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
6/5/20109/22/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Multi-organ dysfunction syndrome secondary to methadone toxicity.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured Physician evaluated and treated the patient in the emergency department following his field resuscitation. Lab studies, an EKG and head CT were ordered and results were noted to be normal. IV fluids and Narcan were administered. A chest CT revealed possible alveolitis with no evidence of pulmonary embolism. Insured Physician recommended admission for observation but the patient refused to be admitted. The patient was discharged to home with verbal and written instructions given to him and his family to observe closely for respiratory difficulty or alteration in mental status.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Altered mental status due to methadone overdose and possible pneumonia.
Principal Injury Giving Rise To The Claim
Plaintiff alleged the Insured Physician failed to recognize an abnormal and prolonged QT interval on the EKG resulting in the patient's sudden cardiac arrest and death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/14/201154-2011-CA-23
County Suit Filed inDate of Final Disposition
Putnam10/2/2012
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
10/2/2012
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$210,000
Loss Adjust Expense Paid to Defense Counsel$78,097
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
Communicate and document patient leaving against medical advice.
 
Updates
 
No updates found.

 

 

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Dr. Mohammad M Kaleem Medical Malpractice Lawsuits - Court Case # 03-665-CA

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200642201
Claim Number :18162
Date Submitted :9/12/2006
 
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
IndividualMohammadMKaleem
Insurer TypeStreet Address of Practice
Licensed524 Zeagler Drive
CityStateZip CodeCounty
PalatkaFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600844 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78625Cardiovascular Disease - Minor Surgery70415

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
12/29/20027/23/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Acute Myocardial Infarction
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
EKG and enzymes
Diagnostic Code :410.9
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis and management of 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
1/16/200403-665-CA
County Suit Filed inDate of Final Disposition
Putnam8/31/2006
Other Defendants Involved in this Claim
Putnam Community Medical Center
Milanick MD, John C
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
9/5/2006
 
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$140,813
All Other Loss Adjustment Expense Paid$52,588
Injured Person's Total Non-Economic Loss$200,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$75,000$0
Wage Loss$156,525$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. JOHN WALSH Medical Malpractice Lawsuits - Court Case # 07028CA52

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200850241
Claim Number :278479
Date Submitted :1/12/2009
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualMary Osborn
Street Address
5814 Reed Rd
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(800) 463 - 37766604(260) 486 - 0785Mary.Osborn@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJOHN WALSH
Insurer TypeStreet Address of Practice
Licensed530 ZEAGLER DRSUITE A
CityStateZip CodeCounty
PALATKAFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
706171$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78805Physicians or Surgeons - major surgery.NOC classification. 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
2/1/20059/16/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
PERIPHERAL VASCULAR DISEASE
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
SURGERY
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
IMPROPER PERFORMANCE OF SURGERY
Principal Injury Giving Rise To The Claim
AMPUTATION OF RIGHT 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
1/28/200707028CA52
County Suit Filed inDate of Final Disposition
Putnam6/23/2008
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
6/30/2008
 
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$21,147
All Other Loss Adjustment Expense Paid$9,225
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
 
 
Date of Change:1/12/2009 1:34:14 PM
Reason for Change:UPDATING ALE ON THIS CASE.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel1672921147
All Other Loss Adjustment Expense Paid67609225

 

 

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Dr. THOMAS B PINSON Medical Malpractice Lawsuits - Court Case # 09-103-CA-53

Indemnity Paid: $150,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200954589
Claim Number :MM250449
Date Submitted :8/18/2009
 
Insurer Information
 
Insurer NameCoverage Type
EVANSTON INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
36-2950161 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCherry ERadin
Street Address
Ten Parkway North
CityStateZip
DeerfieldIL60015
PhoneExtFaxE-Mail Address
(847) 572 - 6085 (847) 572 - 6338radin@markelcorp.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualTHOMASBPINSON
Insurer TypeStreet Address of Practice
Licensed113 W. Hickory Street
CityStateZip CodeCounty
NeoshoMO64850Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MM813933$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME86842Emergency Medicine - Including Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
8/10/20069/23/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented to the emergency room with chest pain that started about four hours before she saw the insured doctor.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured doctor's clinical impression was acute chest pain and wellens' syndrome, and ordered EKG, CBC, chemistries and chest x-rays. The patient expired from a dissecting aortic aneurysm after seeing other docotrs. The autopsy revealed dissecting aortic aneurysm, hemoperocardium, mild aortic arteriosclerosis, acute pulmonary and vesceral congestion, and crebra edema. The cause of death was hemopericardium due to dissecting aortic aneurysm.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
It was alleged the patient expired from a dissecting aortic aneurysm due to the insured doctor's not ordering a CT scan and not noting the widening of the mediastinum.
Principal Injury Giving Rise To The Claim
The patient expired from a dissecting aortic aneurysm.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/5/200909-103-CA-53
County Suit Filed inDate of Final Disposition
Putnam7/23/2009
Other Defendants Involved in this Claim
Vista Staffing Solutions
Putnam Emergency Group, LLC
Amin, MohammadB
Mohammad Basi Amin, MD, PA
Putnam Community Medical Center, LLC
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$150,000
Loss Adjust Expense Paid to Defense Counsel$16,808
All Other Loss Adjustment Expense Paid$0
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$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. Bruce Paley Medical Malpractice Lawsuits - Court Case # 62859-10

Indemnity Paid: $149,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201056033
Claim Number :37744-01
Date Submitted :1/13/2010
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualBruce Paley
Insurer TypeStreet Address of Practice
Licensed2 Cedarford Court
CityStateZip CodeCounty
Palm CoastFL32137Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
46729$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
OS5622Dermatology - No Surgery80256

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FFlagler
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
3/21/200610/8/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented with squamous cell lesions about her arms and legs.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured excised multiple skin lesions.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Plaintiff allege untimely diagnosis and treatment of squamous cell lesion on patient's thumb.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/28/200962859-10
County Suit Filed inDate of Final Disposition
Putnam12/23/2009
Other Defendants Involved in this Claim
Jain, M.D., Vidya
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/23/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$149,000
Loss Adjust Expense Paid to Defense Counsel$26,103
All Other Loss Adjustment Expense Paid$15,553
Injured Person's Total Non-Economic Loss$149,000
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. John Milanick Medical Malpractice Lawsuits - Court Case # 12-518-CA

Indemnity Paid: $149,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201471584
Claim Number :FP4354701
Date Submitted :8/12/2014
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKelly Andrews
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(904) 360 - 3038  kandrews@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJohn Milanick
Insurer TypeStreet Address of Practice
Licensed6500 Crill Avenue, Bldg. 1, Suite 4
CityStateZip CodeCounty
PalatkaFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
FP-CL099475$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME54477Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityMedex Medical Express
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
OtherClinic
Date of OccurrenceDate Reported to Insurer
8/10/20129/13/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Alcohol intoxication.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alcohol breath test.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient left her job due to suspicion of drinking at work.
Severity Of Injury
Emotional Only - Fright, no physical damage

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/13/201212-518-CA
County Suit Filed inDate of Final Disposition
Putnam7/25/2014
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$149,000
Loss Adjust Expense Paid to Defense Counsel$52,328
All Other Loss Adjustment Expense Paid$34,081
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures.Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. JOHN C MILANICK Medical Malpractice Lawsuits - Court Case # 2015-128CA

Indemnity Paid: $125,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201576638
Claim Number : 324856
Date Submitted : 12/31/2015
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W. Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual JOHN C MILANICK
Insurer Type Street Address of Practice
Licensed 6500 Crill Avenue, Building 1,, Suite 4
City State Zip Code County
Palatka FL 32177 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0951772 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME54477 Internal Medicine - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Prison  
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Putnam County Jail
Date of Occurrence Date Reported to Insurer
4/1/2014 11/25/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest wall pain, constipation, bladder control and UTI.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Medical management, imaging and referral to hospital.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Paraplegia.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
4/2/2015 2015-128CA
County Suit Filed in Date of Final Disposition
Putnam 11/23/2015
Other Defendants Involved in this Claim
Cox, David
Medex Medical Express of Palatka, LLC
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $125,000
Loss Adjust Expense Paid to Defense Counsel $40,333
All Other Loss Adjustment Expense Paid $4,372
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
 
Date of Change: 12/31/2015 10:02:09 AM
Reason for Change: Correction to injured person last name.
 
Field Changed Former Value New Value
Injured Person Last Name Caman Carman

 

 

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

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Dr. George Schiffbauer Medical Malpractice Lawsuits - Court Case # 2015-128CA

Indemnity Paid: $125,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201576640
Claim Number : 324857
Date Submitted : 12/31/2015
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W. Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual George   Schiffbauer
Insurer Type Street Address of Practice
Licensed 6500 Crill Avenue, Building 1, Suite 4
City State Zip Code County
Palatka FL 32177 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0951772 $500,000 $1,500,000
Profession or Business Other Profession or Business
Physician Assistant  
License Number Specialty Code & Classification Certification Number
PA2482 Internal Medicine - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Prison  
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Putnam County Jail
Date of Occurrence Date Reported to Insurer
4/1/2014 11/25/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest wall pain, constipation, bladder control and UTI.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Medical management, imaging and referral to hospital.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Paraplegia.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
4/2/2015 2015-128CA
County Suit Filed in Date of Final Disposition
Putnam 11/23/2015
Other Defendants Involved in this Claim
Milanick, John
Cox, David
Medex Medical Express of Palatka, LLC
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $125,000
Loss Adjust Expense Paid to Defense Counsel $480
All Other Loss Adjustment Expense Paid $2,500
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
 
Date of Change: 12/31/2015 9:57:22 AM
Reason for Change: Corrected the spelling of injured person last name.
 
Field Changed Former Value New Value
Injured Person Last Name Caman Carman

 

 

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

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Dr. David S Cox Medical Malpractice Lawsuits - Court Case # 2015-128CA

Indemnity Paid: $125,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201576641
Claim Number : 324858
Date Submitted : 12/21/2015
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual David S Cox
Insurer Type Street Address of Practice
Licensed 6500 Crill Avenue, Building 1, Suite 4
City State Zip Code County
Palatka FL 32177 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0951772 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
PA1560 Internal Medicine - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Prison  
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Putnam County Jail
Date of Occurrence Date Reported to Insurer
4/1/2014 11/25/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest wall pain, constipation, bladder control and UTI.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Medical management, imaging and referral to hospital.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Paraplegia.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
4/2/2015 2015-128CA
County Suit Filed in Date of Final Disposition
Putnam 11/23/2015
Other Defendants Involved in this Claim
Cox, David
Medex Medical Express of Palatka, LLC
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $125,000
Loss Adjust Expense Paid to Defense Counsel $480
All Other Loss Adjustment Expense Paid $2,735
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. Angela Santiago Medical Malpractice Lawsuits - Court Case # 15000250CAAXMX

Indemnity Paid: $115,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201884312
Claim Number : 326566
Date Submitted : 2/12/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Angela   Santiago
Insurer Type Street Address of Practice
Licensed 6440 West Newberry Road Suite 401
City State Zip Code County
Gainesville FL 32605 Alachua
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0928538 $250,000 $750,000
Profession or Business Other Profession or Business
Other  
License Number Specialty Code & Classification Certification Number
ARNP9217962    

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Alachua
City State Zip Code
     
Location where injury occured Other location where injury occured
Physician's Office  
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Physician's office
Date of Occurrence Date Reported to Insurer
2/5/2013 1/28/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Referral patient complaining of back pain with radicular symptoms to the left leg; ultimately diagnosed with disc herniation at L3-4.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Evaluation and management with an order for lumber MRI "ASAP".
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Disputed allegations of failing to timely obtain MRI results and report findings to the neurosurgeon for surgical decompression.
Principal Injury Giving Rise To The Claim
Allegations of a delay in surgery and damage to nerves.
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
6/15/2015 15000250CAAXMX
County Suit Filed in Date of Final Disposition
Putnam 1/29/2018
Other Defendants Involved in this Claim
Florida Neurosurgical Associates, PA
Scott, MD, Eric W
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
1/29/2018
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $115,000
Loss Adjust Expense Paid to Defense Counsel $60,883
All Other Loss Adjustment Expense Paid $22,331
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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Dr. Miguel G Dejuk Medical Malpractice Lawsuits - Court Case # 10-794-CA

Indemnity Paid: $110,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201160807
Claim Number :34771
Date Submitted :6/13/2011
 
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
IndividualMiguelGDejuk
Insurer TypeStreet Address of Practice
Licensed800 Zeagler Dr.
CityStateZip CodeCounty
PalatkaFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601562 06$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME55591Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
5/1/20088/11/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Prostate 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 delay in diagnosis of prostate cancer
Principal Injury Giving Rise To The Claim
Prostate cancer
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
12/8/201010-794-CA
County Suit Filed inDate of Final Disposition
Putnam6/7/2011
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/7/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$110,000
Loss Adjust Expense Paid to Defense Counsel$26,636
All Other Loss Adjustment Expense Paid$4,680
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$188,000$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. EDWARD D RISCH Medical Malpractice Lawsuits - Court Case # 03-520-CA-DIV53

Indemnity Paid: $100,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535956
Claim Number :A02-26640-02
Date Submitted :7/20/2005
 
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
IndividualEDWARDDRISCH
Insurer TypeStreet Address of Practice
LicensedP. O. BOX 8065
CityStateZip CodeCounty
PalatkaFL32178Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
10386$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME39524Surgery - Orthopedic80154

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/6/20027/19/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Arthritis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right total hip replacement, under epidural anesthesia.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Post surgical epidural hematoma resulting in lower extremity paraplegia.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/1/200303-520-CA-DIV53
County Suit Filed inDate of Final Disposition
Putnam6/28/2005
Other Defendants Involved in this Claim
Edwards, CRNA, Willie
De Latorre, M.D., Robert
Putnam Comm 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
6/28/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$100,000
Loss Adjust Expense Paid to Defense Counsel$23,057
All Other Loss Adjustment Expense Paid$14,826
Injured Person's Total Non-Economic Loss$100,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$300,000$1,000,000
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. Charles T Donaldson Medical Malpractice Lawsuits - Court Case # 05-041-CA-53

Indemnity Paid: $100,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640739
Claim Number :SG-AO-04-34944
Date Submitted :5/22/2006
 
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
9821 Katy Freeway, Suite 600
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 243 - 7311nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualCharlesTDonaldson
Insurer TypeStreet Address of Practice
Licensed7 Sea Oats Terrace
CityStateZip CodeCounty
Ormond BeachFL32176Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
4700000046-041$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME43351Emergency Medicine - No Major Surgery80102

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
2/19/200410/21/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient to ER with complaints of dizziness, shortness of breath and diaphoresis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Vitals taken along with chest x-ray.Diagnosed as normal and non-cardiac; patient then discharged.Film re-read and cardiac changes noted; patient on way back to ER and expired
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis
Principal Injury Giving Rise To The Claim
Alleged failure to diagnose cardiac event resulting in death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/12/200505-041-CA-53
County Suit Filed inDate of Final Disposition
Putnam5/19/2006
Other Defendants Involved in this Claim
Elliott, NP, Mark
Putnam Emergency Group
Putnam Community Medical Center, LLC
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
8/23/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$100,000
Loss Adjust Expense Paid to Defense Counsel$13,005
All Other Loss Adjustment Expense Paid$1,665
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. MARK D ELLIOTT Medical Malpractice Lawsuits - Court Case # 05-041-CA-53

Indemnity Paid: $100,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640740
Claim Number :SG-AO-04-34944-ME
Date Submitted :5/22/2006
 
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
9821 Katy Freeway, Suite 600
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 243 - 7311nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMARKDELLIOTT
Insurer TypeStreet Address of Practice
Licensed9934 SE 64th Avenue
CityStateZip CodeCounty
BelleviewFL34420Escambia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
4700000046-041$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
OtherNurse Practitioner
License NumberSpecialty Code & ClassificationCertification Number
RN3069752  

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
2/19/200410/21/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient to ER with complaints of dizziness, shortness of breath and diaphoresis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Vitals taken and chest x-ray; diagnosed as normal; patient discharge; over-read of films revealed cardiac changes and patient advised to return to E.R.;Expired en route.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Diagnosis delay
Principal Injury Giving Rise To The Claim
Alleged delay in diagnose cardiac event resulting in death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/12/200505-041-CA-53
County Suit Filed inDate of Final Disposition
Putnam5/19/2006
Other Defendants Involved in this Claim
Putnam Emergency Group
Putnam Community Medical Center
Donaldson, M.D., Charles T
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
8/23/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$100,000
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
Unknown
 
Updates
 
No updates found.

 

 

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Dr. Daniel Kreisman Medical Malpractice Lawsuits - Court Case # 11-297-CA

Indemnity Paid: $100,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201472208
Claim Number : 284254
Date Submitted : 9/30/2014
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Tiffany D Taylor
Street Address
13450 West Sunrise Blvd
City State Zip
Sunrise FL 33323
Phone Ext Fax E-Mail Address
(877) 320 - 0748     TTaylor@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Daniel   Kreisman
Insurer Type Street Address of Practice
Licensed 811 N. Summit Street
City State Zip Code County
Crescent City FL 32112 Putnam
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0067852 $250,000 $750,000
Profession or Business Other Profession or Business
Physician Assistant  
License Number Specialty Code & Classification Certification Number
PA3478 Family Physicians or General Practitioners - Minor Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Physician's Office  
Name of Institution Code
N/A 000000
Location of Institutional Injury Other Location of Institutional Injury
Other Practitioner's Office
Date of Occurrence Date Reported to Insurer
4/12/2010 2/14/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Weight loss ultimatley diagnosed as Tuberculosis by another medical practioner.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to diagnose patient with Tuberculosis in a timely manner resulting in exposure to the patient's wife and friends.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose Tuberculosis.
Principal Injury Giving Rise To The Claim
Alleged delay in diagnosis of Turberculosis leading to alleged additional lung injury.
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
7/11/2011 11-297-CA
County Suit Filed in Date of Final Disposition
Putnam 9/12/2014
Other Defendants Involved in this Claim
Sunrise Primary Care
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/5/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $100,000
Loss Adjust Expense Paid to Defense Counsel $58,195
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 Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Unknown
 
Updates
 
No updates found.

 

 

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Dr. Bold Hood Medical Malpractice Lawsuits - Court Case # 2014 CA 000080

Indemnity Paid: $99,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201574046
Claim Number : FL-LMMC-02
Date Submitted : 4/1/2015
 
Insurer Information
 
Insurer Name Coverage Type
APPLIED MEDICO-LEGAL SOLUTIONS RISK RETENTION GROUP, INC. Primary
Insurer FEIN Professional License Number
81-0603029  
Insurer Contact Information
Type First Name MI Last Name
Individual Julie   Moore
Street Address
101 E. Park Blvd.
City State Zip
Plano TX 75074
Phone Ext Fax E-Mail Address
(866) 520 - 6896     jmontague@bpmp.com
 
Insured Information
 
Type First Name MI Last Name
Individual Bold   Hood
Insurer Type Street Address of Practice
Licensed 755 Rinchart Road
City State Zip Code County
Lake Mary FL 32746 Seminole
Policy Number Per Claim Policy Limits Aggregate Policy Limits
G-AMS-116230 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME63113 Emergency Medicine - No Major Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
PUTNAM COMMUNITY MEDICAL CENTER 100232
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
10/3/2012 8/12/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Perianal abscess with sepsis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Incision and drainage of perirectal abscess.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Plaintiff alleged that Insured Physician improperly performed the procedure resulting in damage to her internal and external sphincters.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
2/25/2014 2014 CA 000080
County Suit Filed in Date of Final Disposition
Putnam 3/24/2015
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 Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/18/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $99,000
Loss Adjust Expense Paid to Defense Counsel $17,184
All Other Loss Adjustment Expense Paid $11,000
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Refer pediatric patients to pediatric surgeons.
 
Updates
 
No updates found.

 

 

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

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Dr. GREGORY CONNER Medical Malpractice Lawsuits - Court Case # 11-512-CA

Indemnity Paid: $75,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201573282
Claim Number : TH-10-LLA-111056
Date Submitted : 1/22/2015
 
Insurer Information
 
Insurer Name Coverage Type
Team Health, Inc. Primary
Insurer FEIN Professional License Number
62-1562558  
Insurer Contact Information
Type First Name MI Last Name
Individual Kathy A Stockton
Street Address
9821 Katy Freeway
City State Zip
Houston TX 77024
Phone Ext Fax E-Mail Address
(713) 935 - 2404   (713) 461 - 8130 kathy_stockton@westernlitigation.com
 
Insured Information
 
Type First Name MI Last Name
Individual GREGORY   CONNER
Insurer Type Street Address of Practice
Self-Insurer 101 LAUREL WOOD WAY UNIT 201
City State Zip Code County
SAINT AUGUSTINE FL 32086 St. Johns
Policy Number Per Claim Policy Limits Aggregate Policy Limits
6796646 $250,000 $750,000
Profession or Business Other Profession or Business
Osteopathic Physician  
License Number Specialty Code & Classification Certification Number
OS9589 Emergency Medicine - No Major Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Putnam
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
PUTNAM COMMUNITY MEDICAL CENTER 100232
Location of Institutional Injury Other Location of Institutional Injury
Critical Care Unit  
Date of Occurrence Date Reported to Insurer
4/4/2009 4/1/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
TESTICULAR TORSION
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
US
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
NO EVIDENCE OF TORSION
Principal Injury Giving Rise To The Claim
LOSS OF TESTICLE
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
11/18/2011 11-512-CA
County Suit Filed in Date of Final Disposition
Putnam 1/22/2015
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 Decision Other
No Court Proceedings.  
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
12/11/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $75,000
Loss Adjust Expense Paid to Defense Counsel $51,662
All Other Loss Adjustment Expense Paid $15,983
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
UNKNOWN
 
Updates
 
No updates found.

 

 

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Dr. Vidya S Jain Medical Malpractice Lawsuits - Court Case # 09-027-CA

Indemnity Paid: $75,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201058875
Claim Number :267941
Date Submitted :10/21/2010
 
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
IndividualVidyaSJain
Insurer TypeStreet Address of Practice
Licensed800 Zeagler Drive, Suite 100
CityStateZip CodeCounty
PalatkaFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
347482$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME57658Surgery - Hand 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPutnam
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
OtherExam room
Date of OccurrenceDate Reported to Insurer
1/22/20072/26/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Status post removal of squamous cell carcinoma, the patient presented to the insured for a non-healing wound on right thumb.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured physician treated patient conservatively, recommending that the patient begin hydrogen peroxide soaks and a CT scan was ordered.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Loss of thumb.
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
8/5/200909-027-CA
County Suit Filed inDate of Final Disposition
Putnam9/24/2010
Other Defendants Involved in this Claim
Paley, D.O., Bruce H
Bruce H. Paley, P.A.
Vidya S. Jain, M.D., 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
9/23/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$75,000
Loss Adjust Expense Paid to Defense Counsel$109,000
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$75,000
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
Unkown.
 
Updates
 
No updates found.

 

 

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

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Dr. MOHAMED AKHIYAT Medical Malpractice Lawsuits - Court Case # 05-240-CA

Indemnity Paid: $70,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200851550
Claim Number :31684-01
Date Submitted :11/25/2008
 
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
IndividualMOHAMED AKHIYAT
Insurer TypeStreet Address of Practice
Licensed6061 St. Johns Avenue, Ste A
CityStateZip CodeCounty
PalatkaFL32177Putnam
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
47430$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME59459Surgery - Obstetrics - Gynecology80153

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPutnam
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
PUTNAM COMMUNITY MEDICAL CENTER100232
Location of Institutional InjuryOther Location of Institutional Injury
Labor and Delivery Room 
Date of OccurrenceDate Reported to Insurer
11/21/200110/22/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Infant was deliverd by C-section w/o complication and followed by a pediatrician and nursing staff.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured delivered infant by C-section w/o complication and handed child to the pediatrician.Plaintiff alleges insd. should have verbally advised the pediatrician that the infant's mother was a hepatitis B carrier even though this information was disclosed by insd. multiple times according to protocol in written form, which was provided to the pediatrician and hospital.Infant was discharged by pediatrician w/o receiving a hepatitis B innoculation.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
The child has tested positive as a carrier of hepatitis B.
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
5/21/200505-240-CA
County Suit Filed inDate of Final Disposition
Putnam11/5/2008
Other Defendants Involved in this Claim
Putnam Community Medical Center
Kalmadi, M.D., Sujith
Family Medical Center
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
OtherSettlement reached during trial
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/5/2008
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$70,000
Loss Adjust Expense Paid to Defense Counsel$64,705
All Other Loss Adjustment Expense Paid$27,169
Injured Person's Total Non-Economic Loss$70,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$2,431$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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