Medical Malpractice Cases

Medical Malpractice Cases In Santa Rosa County Florida

Dr. Matthew Warner Medical Malpractice Lawsuits - Court Case # 04-618-CA

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200639405
Claim Number :SG-02-32657
Date Submitted :2/6/2006
 
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
2000 West Sam Houston Parkway South, 19th Floor; One Briarlake Plaza
CityStateZip
HoustonTX77042-361
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMatthew Warner
Insurer TypeStreet Address of Practice
Licensed4493 Luke Avenue
CityStateZip CodeCounty
DestinFL32541Okaloosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
4700000046-021$1,000,000$5,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME65994Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
12/18/20033/23/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Child brought to E.D. and was told to take to other facility for fever, vomiting, achiness and red splotches on legs.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Seen atSanta Rosa by Dr. Warner.Ordered Flu test and throat swab and given Gatorage.Discharged with prescription for Amoxil and tylenol or Motrin.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis
Principal Injury Giving Rise To The Claim
Alleged failure to diagnose bacterial meningitis resulting in death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/23/200404-618-CA
County Suit Filed inDate of Final Disposition
Santa Rosa1/30/2006
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
10/24/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$250,000
Loss Adjust Expense Paid to Defense Counsel$39,911
All Other Loss Adjustment Expense Paid$10,631
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. Jerry D Leventhal Medical Malpractice Lawsuits - Court Case # 2004-CA-000720

Indemnity Paid: $250,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200642084
Claim Number :19989
Date Submitted :10/11/2006
 
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
IndividualJerryDLeventhal
Insurer TypeStreet Address of Practice
Licensed10 Hanover Drive
CityStateZip CodeCounty
Flagler BeachFL32136Flagler
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600439 02$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME69470Family Physicians or General Practitioners - No Surgery65401

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
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
6/14/20035/14/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Shin wound
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Clean and dress wound prescribe Augmentin
Diagnostic Code :682.6
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose vibrio vulnificus and administer appropriate antibiotics
Principal Injury Giving Rise To The Claim
Fasciotomy and skin grafting
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/25/20042004-CA-000720
County Suit Filed inDate of Final Disposition
Santa Rosa9/6/2006
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
8/17/2006
 
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$19,738
All Other Loss Adjustment Expense Paid$18,660
Injured Person's Total Non-Economic Loss$250,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$400,000$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
 
 
Date of Change:10/11/2006 11:48:31 AM
Reason for Change:Report updated to reflect Court document date of Final Dismissal of 09/06/06.
 
Field ChangedFormer ValueNew Value
Date of Final Disposition11-AUG-0606-SEP-06

 

 

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Dr. Ancil L Lindley Medical Malpractice Lawsuits - Court Case # 57-2001-CA-000853

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200536464
Claim Number :14192
Date Submitted :8/29/2005
 
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
IndividualAncilLLindley
Insurer TypeStreet Address of Practice
Licensed5250 Stewart Street
CityStateZip CodeCounty
MiltonFL32570Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600006 02$3,000,000$5,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME19922Radiology - Diagnostic - Minor Surgery2701

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FEscambia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
JAY HOSPITAL100048
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
1/28/20007/19/2001
 
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
Screening mammogram, spot compression views, and ultrasound
Diagnostic Code :233.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis of breast cancer
Principal Injury Giving Rise To The Claim
Breast cancer
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
1/28/200257-2001-CA-000853
County Suit Filed inDate of Final Disposition
Santa Rosa8/17/2005
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
8/17/2005
 
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$145,985
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$200,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$281,639$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. John Lee Medical Malpractice Lawsuits - Court Case # 08-00157CA

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200954663
Claim Number :36794-01
Date Submitted :8/25/2009
 
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
IndividualJohn Lee
Insurer TypeStreet Address of Practice
Licensed4252 Woodbine Road
CityStateZip CodeCounty
PaceFL32571Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
45202$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME50043Surgery - Obstetrics - Gynecology80153

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WEST FLORIDA REG. MED. CTR (PENSACOLA)100231
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
12/16/20053/5/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Severe adhesive disease, cystic ovaries.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Bilateral, salpingo-oophorectomy, appendectomy, partial omentectomy and lysis of adhesions.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Disputed allegations of delay in diagnosis of a bowel perforation, resulting in additional treatment and delayed recovery.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage.Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/21/200808-00157CA
County Suit Filed inDate of Final Disposition
Santa Rosa8/3/2009
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
8/3/2009
 
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$6,330
All Other Loss Adjustment Expense Paid$3,585
Injured Person's Total Non-Economic Loss$200,000
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. Howell J Martin Medical Malpractice Lawsuits - Court Case # 12-001633-CA

Indemnity Paid: $200,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201469459
Claim Number :42345
Date Submitted :1/17/2014
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualHowellJMartin
Insurer TypeStreet Address of Practice
Licensed545 Brent Lane
CityStateZip CodeCounty
PensacolaFL32503Escambia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1601332 08$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME23750Surgery - Urological 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
9/24/20108/21/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Split stream
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
TURP
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged unnecessary performance of TURP
Principal Injury Giving Rise To The Claim
Urethral strictures and voiding dysfunction
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
12/12/201212-001633-CA
County Suit Filed inDate of Final Disposition
Santa Rosa1/2/2014
Other Defendants Involved in this Claim
Martin & Plunkett, MD, PA
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
1/2/2014
 
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$25,646
All Other Loss Adjustment Expense Paid$11,130
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$15,382$50,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. Jerry D Leventhal Medical Malpractice Lawsuits - Court Case # 05-324

Indemnity Paid: $165,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200538544
Claim Number :21377
Date Submitted :12/2/2005
 
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
IndividualJerryDLeventhal
Insurer TypeStreet Address of Practice
LicensedPO Box 6299
CityStateZip CodeCounty
NavarreFL32566Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600439 03$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME69470Family Physicians or General Practitioners - No Surgery65401

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
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
3/2/20041/6/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Left-sided weakness
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
CT scan
Diagnostic Code :436.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose and treat left-sided weakness
Principal Injury Giving Rise To The Claim
Non-hemorrhagic infarction
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/12/200505-324
County Suit Filed inDate of Final Disposition
Santa Rosa11/17/2005
Other Defendants Involved in this Claim
Total Family Health Care
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/17/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$165,000
Loss Adjust Expense Paid to Defense Counsel$10,552
All Other Loss Adjustment Expense Paid$8,232
Injured Person's Total Non-Economic Loss$165,000
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
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. Robert Althar Medical Malpractice Lawsuits - Court Case # 08 394CA

Indemnity Paid: $150,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201058446
Claim Number :36146-01
Date Submitted :9/3/2010
 
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
IndividualRobert Althar
Insurer TypeStreet Address of Practice
Licensed4225 Woodbine Road, Suite E
CityStateZip CodeCounty
PaceFL32571Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
9903$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME49321Surgery - General80143

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
1/13/20059/18/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Recurrent incarcerated ventral hernia.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Laparoscopic ventral hernia repair.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Disputed allegations of failing to timely identify and repair bowel perforation, resulting in additional surgery and scarring.
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
3/17/200808 394CA
County Suit Filed inDate of Final Disposition
Santa Rosa8/16/2010
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
After court verdict and prior to filing of notice of appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Othersettlement achieved post trial, resulting in a dis
Arbitration
Claim not subject to Arbitration.
Date of Payment
8/16/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$150,000
Loss Adjust Expense Paid to Defense Counsel$54,541
All Other Loss Adjustment Expense Paid$62,172
Injured Person's Total Non-Economic Loss$150,000
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. Robert Althar Medical Malpractice Lawsuits - Court Case # 572008CA570CA

Indemnity Paid: $150,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201058625
Claim Number :36243-01
Date Submitted :9/22/2010
 
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
IndividualRobert Althar
Insurer TypeStreet Address of Practice
Licensed4225 Woodbine Road, Ste E
CityStateZip CodeCounty
PaceFL32571Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
9903$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME49321Surgery - General80143

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
6/28/200510/9/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Small bowel obstruction.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Exploratory laparotomy; lysis of extensive adhesions; small bowel resection and primary anastomosis.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Disputed allegations of negligently causing bowel perforation, resulting in sepsis, further surgeries and heart damage.
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
5/1/2008572008CA570CA
County Suit Filed inDate of Final Disposition
Santa Rosa9/1/2010
Other Defendants Involved in this Claim
Santa Rosa Medical Center
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/1/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$150,000
Loss Adjust Expense Paid to Defense Counsel$35,756
All Other Loss Adjustment Expense Paid$15,681
Injured Person's Total Non-Economic Loss$150,000
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. Zaher Kalaji Medical Malpractice Lawsuits - Court Case # 06 00671

Indemnity Paid: $125,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201059228
Claim Number :SGI-05LC-69982
Date Submitted :11/23/2010
 
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
IndividualZaher Kalaji
Insurer TypeStreet Address of Practice
Licensed2340 Arriviste Way
CityStateZip CodeCounty
PensacolaFL32504Escambia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
CMI AE 0731 001$1,000,000$1,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME73792Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/5/200311/18/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pheochromocytoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged failure to properly treat, failure to admit
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Failure to admit and failure to properly work up
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
5/19/200606 00671
County Suit Filed inDate of Final Disposition
Santa Rosa11/19/2010
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
11/2/2010
 
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$151,121
All Other Loss Adjustment Expense Paid$32,198
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.E.d. visit not related to underlying medical condition.
 
Updates
 
No updates found.

 

 

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Dr. Leon E Paulos Medical Malpractice Lawsuits - Court Case # 2013-CA-000620

Indemnity Paid: $125,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470941
Claim Number :13-0023-A-10
Date Submitted :6/4/2014
 
Insurer Information
 
Insurer NameCoverage Type
FD INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
20-3704679 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualLindaDCollins
Street Address
4651 Salisbury Road, Suite 410
CityStateZip
JacksonvilleFL32256
PhoneExtFaxE-Mail Address
(904) 296 - 2887214(904) 296 - 1245lcollins@fldic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualLeonEPaulos
Insurer TypeStreet Address of Practice
Licensed324 10th Avenue, Suite 172
CityStateZip CodeCounty
Salt Lake CityUT84103Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MG000700$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME102290Surgery - Orthopedic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
GULF BREEZE HOSPITAL110003
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
8/24/20101/14/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to insured with a history of locking and catching knee, and a dislocating right knee cap.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
High tibial osteotomy procedure.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None made.
Principal Injury Giving Rise To The Claim
Alleging insured performed an experimental osteotomy procedure utilizing an unproven product off-label.
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
6/20/20132013-CA-000620
County Suit Filed inDate of Final Disposition
Santa Rosa5/8/2014
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
5/8/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$125,000
Loss Adjust Expense Paid to Defense Counsel$14,750
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Circumstances of this case have been discussed with the insured and Risk Management was notified.
 
Updates
 
No updates found.

 

 

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Dr. Robert Althar Medical Malpractice Lawsuits - Court Case # 07-284CA

Indemnity Paid: $125,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201056564
Claim Number :33830-01
Date Submitted :2/23/2010
 
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
IndividualRobert Althar
Insurer TypeStreet Address of Practice
Licensed4225 Woodbine Road, Suite E
CityStateZip CodeCounty
PaceFL32571Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
9903$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME49321Surgery - General80143

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FOkaloosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Patient's Home 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
8/20/20043/6/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Gall bladder polyps and abdominal pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patient underwent uneventful laparoscopic cholecystectomy. It was alleged that the patient suffered a bile leak, resulting in the formation of a retrohepatic abscess causing sepsis and death.The allegations were unfounded as the Medical Examiner could not identify a bile leak or say where the alleged bile leak occurred.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
It was alleged that the insured should have instructed the patient to go to the ER instead of her PCP, after receiving a phone call from the patient reporting an episode of vomiting and diarrhea.At the time of the call, the patient was 22 days post surgery and the insured was in the OR performing surgery on a different patient.
Principal Injury Giving Rise To The Claim
Death of this 39 year old female.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/10/200707-284CA
County Suit Filed inDate of Final Disposition
Santa Rosa2/2/2010
Other Defendants Involved in this Claim
Andem, M.D., Efiong
DFS Walk-In Clinic
Chowdhury, P.A., Anwar
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
2/2/2010
 
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$137,087
All Other Loss Adjustment Expense Paid$121,330
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
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. Richard S Vanderburg Medical Malpractice Lawsuits - Court Case # 04-16-CA01-PM-D

Indemnity Paid: $80,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200534796
Claim Number :502252
Date Submitted :3/31/2005
 
Insurer Information
 
Insurer NameCoverage Type
AMERICAN HEALTHCARE INDEMNITY COMPANYPrimary
Insurer FEINProfessional License Number
59-2048400 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualTerryMBinns
Street Address
1888 Century Park East, Suite 800
CityStateZip
Los AngelesCA90067
PhoneExtFaxE-Mail Address
(310) 556 - 7488 (310) 556 - 7400Tbinns@scpie-ahi.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRichardSVanderburg
Insurer TypeStreet Address of Practice
Licensed6044 Doctors Park
CityStateZip CodeCounty
MiltonFL32570Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
53386$250,000$750,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS6849Surgery - Obstetrics - Gynecology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityGulf Coast Women's Health Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
10/9/20017/25/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Ovarian mass, severe adhesions.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Left salpingo-oophorectomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Right inguinal nerve injury from Trocar used during OB/GYN surgery.
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
1/4/200404-16-CA01-PM-D
County Suit Filed inDate of Final Disposition
Santa Rosa3/2/2005
Other Defendants Involved in this Claim
Gulf Coast Physician Services, Inc.
Gulf Coast Women's Health Center
Vanderburg, Estate, Antoinette
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
3/2/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$80,000
Loss Adjust Expense Paid to Defense Counsel$22,574
All Other Loss Adjustment Expense Paid$2,400
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
Interview insured, review interrogatories, deposition, review expert opinions., etc.
 
Updates
 
No updates found.

 

 

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Dr. Michael C Williams Medical Malpractice Lawsuits - Court Case # 05-181CA

Indemnity Paid: $75,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200848109
Claim Number :SGI-04-XS-66559
Date Submitted :1/3/2008
 
Insurer Information
 
Insurer NameCoverage Type
EVEREST INDEMNITY INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
22-3520347 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancyJThomas
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMichaelCWilliams
Insurer TypeStreet Address of Practice
Licensed554 CORAL COURT UNIT 206
CityStateZip CodeCounty
FORT WALTON BEACHFL32548Okaloosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
6500000254-071$1,000,000$1,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85517Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
7/2/20038/23/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
LACERATION TO LEFT LEG
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ALLEGED FAILURE TO TIMELY ASSESS IMPACT INJURY
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
DELAY IN ASSESSMENT
Principal Injury Giving Rise To The Claim
NECROTIZING FASCIITIS AND DEBRIDEMENT SURGERIES
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/25/200505-181CA
County Suit Filed inDate of Final Disposition
Santa Rosa1/2/2008
Other Defendants Involved in this Claim
SANTA ROSA MEDICAL CENTER
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
9/11/2007
 
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$11,428
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. Leon E Paulos Medical Malpractice Lawsuits - Court Case # 2013-CA-001214

Indemnity Paid: $50,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201470942
Claim Number :13-0172-A-11
Date Submitted :6/4/2014
 
Insurer Information
 
Insurer NameCoverage Type
FD INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
20-3704679 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualLindaDCollins
Street Address
4651 Salisbury Road, Suite 410
CityStateZip
JacksonvilleFL32256
PhoneExtFaxE-Mail Address
(904) 296 - 2887214(904) 296 - 1245lcollins@fldic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualLeonEPaulos
Insurer TypeStreet Address of Practice
Licensed324 10th Avenue, Suite 172
CityStateZip CodeCounty
Salt Lake CityUT84103Out of state
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MG000700$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME102290Surgery - Orthopedic 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityAndrews Institute Surgery Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
4/6/20118/7/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to insured with left knee pain that had continued over several years.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
MRI and left distal femur curettage and bone grafting.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None made.
Principal Injury Giving Rise To The Claim
Alleging the use of Kryptonite bone cement in an off-label manner in a weight-bearing capacity; conducting a clinical trial without informing the patient, resulting in the patient having to undergo multiple surgical procedures and medical treatments to correct the damage.
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
11/4/20132013-CA-001214
County Suit Filed inDate of Final Disposition
Santa Rosa5/8/2014
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
5/8/2014
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$50,000
Loss Adjust Expense Paid to Defense Counsel$18,793
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Circumstances of this case have been discussed with the insured and Risk Management was notified.
 
Updates
 
No updates found.

 

 

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Dr. GEORGE D WATTS Medical Malpractice Lawsuits - Court Case # 2006-CA-000021

Indemnity Paid: $20,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201160025
Claim Number :141027
Date Submitted :6/12/2012
 
Insurer Information
 
Insurer NameCoverage Type
PROASSURANCE CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
38-2317569 
Insurer Contact Information
TypeEntity Name
EntityProAssurance Casualty Company
Street Address
14497 North Dale Mabry Hwy., Suite 115-N
CityStateZip
TampaFL33618-2047
PhoneExtFaxE-Mail Address
(813) 969 - 2010 (813) 969 - 2120SNorris@ProAssurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGEORGEDWATTS
Insurer TypeStreet Address of Practice
Licensed6007 Berryhill Road
CityStateZip CodeCounty
MiltonFL32570-4008Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP36665$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME44130Surgery - Orthopedic00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
10/7/200411/7/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Crush injury to right ankle for which plaintiff had undergone ORIF with external fixator.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right ankle fusion.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Alleged screws which were too long were placed across ankle arthrodesis site penetrating subtalar joint resulting in pain, loss of motion and ultimately amputation.
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
1/30/20062006-CA-000021
County Suit Filed inDate of Final Disposition
Santa Rosa1/31/2011
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
2/15/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$20,000
Loss Adjust Expense Paid to Defense Counsel$106,341
All Other Loss Adjustment Expense Paid$50,371
Injured Person's Total Non-Economic Loss$20,000
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:6/12/2012 10:59:48 AM
Reason for Change:State Report updated to reflect additional legal fees and expenses paid.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel104721106341
All Other Loss Adjustment Expense Paid5006750371

 

 

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Dr. Michael Hartsfield Medical Malpractice Lawsuits - Court Case # 2011-0075-CA

Indemnity Paid: $16,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201160634
Claim Number :40652-01
Date Submitted :5/19/2011
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMichael Hartsfield
Insurer TypeStreet Address of Practice
Licensed5750 Berryhill Road
CityStateZip CodeCounty
MiltonFL32570Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
6683$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME26694Surgery - Orthopedic80154

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
GULF BREEZE HOSPITAL110003
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/27/20089/7/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Substantial degenerative disease, left knee.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Total knee replacement arthroplasty, left knee.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Disputed allegations insured negligently performed total knee replacement, requiring revision surgery.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage.Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/1/20112011-0075-CA
County Suit Filed inDate of Final Disposition
Santa Rosa5/2/2011
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
5/2/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$16,000
Loss Adjust Expense Paid to Defense Counsel$2,424
All Other Loss Adjustment Expense Paid$1,539
Injured Person's Total Non-Economic Loss$16,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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Dr. WILLIAM H HASS Medical Malpractice Lawsuits - Court Case # 10001276CA

Indemnity Paid: $10,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201469308
Claim Number :C138050
Date Submitted :1/6/2014
 
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
IndividualWILLIAMHHASS
Insurer TypeStreet Address of Practice
Licensed3754 HIGHWAY 90, SUITE 120
CityStateZip CodeCounty
PACEFL32571Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
EO000008877-02 $1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME69740Additional Charges:Employed Nurse Anesthetists 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
PACE SURGERY CENTER14960664
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
7/17/20097/17/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
PATIENT WAS SCHEDULED TO UNDERGO A LEFT SHOULDER ROTATOR CUFF SURGERY.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
MONITORS WERE ATTACHED IN THE OPERATING ROOM FOR BLOODPRESSURE. MEDICATIONS WERE PREPARED TO LOWER THE BLOOD PRESSURE. BEFORE ANY DRUGS WERE ADMINISTERED, PATIENT SEEMED SHORT OF BREATH AND HAD A SEIZURE. CPR WAS STARTED. EPINEPHRINE AND ATROPHINE WAS ADMINISTERED.911 WAS CALLED TO TRANSFER TO ANOTHER HOSPITAL. PATIENTDIED ON THE WAY.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
NONE DETECTED
Principal Injury Giving Rise To The Claim
ALLEGED RESUSITATION EFFORTS WERE BELOW STANDARD OF CARE.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/24/201010001276CA
County Suit Filed inDate of Final Disposition
Santa Rosa9/27/2013
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
10/1/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$10,000
Loss Adjust Expense Paid to Defense Counsel$116,000
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. Salvatore A Vernali Medical Malpractice Lawsuits - Court Case # 2008 ca 894

Indemnity Paid: $10,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200953874
Claim Number :59144501
Date Submitted :6/9/2009
 
Insurer Information
 
Insurer NameCoverage Type
PHYSICIANS INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
13-4235490 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJamesCO'Hare
Street Address
3200 NE 14th st
CityStateZip
Pompano BeachFL33062
PhoneExtFaxE-Mail Address
(954) 788 - 5610 (954) 788 - 5367johare@picinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualSalvatoreAVernali
Insurer TypeStreet Address of Practice
Licensed5937 Berryhill rd
CityStateZip CodeCounty
MiltonFL32570Santa Rosa
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
131696$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME61471Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FSanta Rosa
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SANTA ROSA MEDICAL CENTER100124
Location of Institutional InjuryOther Location of Institutional Injury
OtherER
Date of OccurrenceDate Reported to Insurer
2/26/20071/28/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Alleged faoilure to diagnose and timely treat a stroke causing left sided weakness
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
physical examination in the emergency room
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
failure to timely diagnose a cerebral vascular accident
Principal Injury Giving Rise To The Claim
left sided weakness
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/23/20082008 ca 894
County Suit Filed inDate of Final Disposition
Santa Rosa4/30/2009
Other Defendants Involved in this Claim
Warner, Matthew A
Santa Rosa med ctr
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
4/30/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$10,000
Loss Adjust Expense Paid to Defense Counsel$59,778
All Other Loss Adjustment Expense Paid$9,176
Injured Person's Total Non-Economic Loss$10,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
none taken nor suggested to Dr Vernali
 
Updates
 
No updates found.

 

 

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Dr. MICHAEL J CALUDA Medical Malpractice Lawsuits - Court Case # 04-30-CA01-PM-D

Indemnity Paid: $500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200744895
Claim Number :18518
Date Submitted :7/30/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMICHAELJCALUDA
Insurer TypeStreet Address of Practice
Licensed1717 North E Street, Suite 434
CityStateZip CodeCounty
PensacolaFL32501Escambia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600314 02$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME76005Surgery - General2101

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MEscambia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityThe SurgeryGroup
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
1/11/20029/12/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Infiltrating carcinoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Transhiatal esophagectomy
Diagnostic Code :862.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged injury to phrenic nerve
Principal Injury Giving Rise To The Claim
Shortness of breath
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
1/12/200404-30-CA01-PM-D
County Suit Filed inDate of Final Disposition
Santa Rosa7/16/2007
Other Defendants Involved in this Claim
Rubey, MD, Robert F
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
3/15/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500
Loss Adjust Expense Paid to Defense Counsel$17,740
All Other Loss Adjustment Expense Paid$9,796
Injured Person's Total Non-Economic Loss$500
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:7/30/2007 1:55:08 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 07/16/2007
 
Field ChangedFormer ValueNew Value
Date of Final Disposition06-MAR-0716-JUL-07

 

 

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Dr. Robert F Rubey Medical Malpractice Lawsuits - Court Case # 04-30-CA01-PM-D

Indemnity Paid: $500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200744896
Claim Number :18519
Date Submitted :3/21/2007
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertFRubey
Insurer TypeStreet Address of Practice
Licensed1717 North E Street, Suite 434
CityStateZip CodeCounty
PensacolaFL32501Escambia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600314 02$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME28242Surgery - Vascular102

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MEscambia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityThe Surgery Group
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
1/11/20029/12/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Infiltrating carcinoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Transhiatal esophagectomy
Diagnostic Code :862.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged injury to phrenic nerve
Principal Injury Giving Rise To The Claim
Shortness of breath
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
1/12/200404-30-CA01-PM-D
County Suit Filed inDate of Final Disposition
Santa Rosa3/6/2007
Other Defendants Involved in this Claim
Caluda, MD, Michael J
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
3/15/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$500
Loss Adjust Expense Paid to Defense Counsel$6,143
All Other Loss Adjustment Expense Paid$2,357
Injured Person's Total Non-Economic Loss$500
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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