Medical Malpractice Cases

Medical Malpractice Cases In Santa Rosa County Florida

Dr. NATHAN W PATTERSON Medical Malpractice Lawsuits - Court Case # 12-1612-CA

Indemnity Paid: $1,650,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201678809
Claim Number : 168273
Date Submitted : 8/1/2016
 
Insurer Information
 
Insurer Name Coverage Type
PROASSURANCE CASUALTY COMPANY Primary
Insurer FEIN Professional License Number
38-2317569  
Insurer Contact Information
Type First Name MI Last Name
Individual Denise   Stokes
Street Address
100 Brookwood Place
City State Zip
Birmingham AL 35209
Phone Ext Fax E-Mail Address
(205) 802 - 4790     dstokes@proassurance.com
 
Insured Information
 
Type First Name MI Last Name
Individual NATHAN W PATTERSON
Insurer Type Street Address of Practice
Licensed 1040 Gulf Breeze Pkwy, Suite 207
City State Zip Code County
Gulf Breeze FL 32561 Santa Rosa
Policy Number Per Claim Policy Limits Aggregate Policy Limits
MP60794 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME91684 Surgery - Plastic  

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 Santa Rosa
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
GULF BREEZE HOSPITAL 110003
Location of Institutional Injury Other Location of Institutional Injury
Operating Suite  
Date of Occurrence Date Reported to Insurer
10/8/2010 10/14/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Umbilical hernia, saline implants
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Abdominoplasty, liposuction of hips, umbilical hernia repair, exchange of breast implants
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
no misdiagnosis reported
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
1/14/2013 12-1612-CA
County Suit Filed in Date of Final Disposition
Santa Rosa 6/19/2016
Other Defendants Involved in this Claim
Wiles, Ronald
Patterson Plastic Surgery PA
Riley, Scott A
Pensacola Nephrology PA
Gary, John D
Gore, Angela A
Kellen, David
Rao, Rammohan S
Gulf Breeze Hospital
Apollo MD
Dolister, Michael J
Pulmonary Medicine PA
Live Oak Med Association
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 Decision Other
Other Settled
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
6/19/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $1,650,000
Loss Adjust Expense Paid to Defense Counsel $233,449
All Other Loss Adjustment Expense Paid $97,322
Injured Person's Total Non-Economic Loss $1,650,000
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
Insured discussed case with defense counsel, insurance personnel, and medical experts.
 
Updates
 
 
Date of Change: 7/7/2016 9:27:06 AM
Reason for Change: updated indemnity amount
 
Field Changed Former Value New Value
Indemnity Paid 0 1650000
Injured Person Total Non-Economic Loss 0 1650000
Settlement Reached 0 1
 
Date of Change: 8/1/2016 4:48:41 PM
Reason for Change: updated ALAE information
 
Field Changed Former Value New Value
Amount of Loss Adjustment Expense Paid to Defense Counsel 153064 233449
All Other Loss Adjustment Expense Paid 68911 97322

 

 

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Dr. Steven Kronlage Medical Malpractice Lawsuits - Court Case # 2011-802-CA

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201575038
Claim Number : 273222
Date Submitted : 6/25/2015
 
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 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 Steven   Kronlage
Insurer Type Street Address of Practice
Licensed 1040 Gulf Breeze Suite 209
City State Zip Code County
Gulf Breeze FL 32561 Santa Rosa
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0480867 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME86563 Surgery - Orthopedic  

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 Escambia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Outpatient Facility Surgical Center
Name of Institution Code
PACE SURGERY CENTER 14960664
Location of Institutional Injury Other Location of Institutional Injury
Operating Suite  
Date of Occurrence Date Reported to Insurer
8/4/2009 10/16/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient was undergoing wrist surgery and was burned from a hot wrist tower which was sterilized by surgical center staff.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right wrist arthroscopic surgery.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Alleged burns to wrist and forearm.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
9/19/2011 2011-802-CA
County Suit Filed in Date of Final Disposition
Santa Rosa 6/12/2015
Other Defendants Involved in this Claim
Pace Ambulatory Surgery Center, LLC
Stage of Legal System at which Settlement was Reached or Award Made
After appeal.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
Judgment for the plaintiff after appeal ...  
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/8/2015
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $500,000
Loss Adjust Expense Paid to Defense Counsel $550,000
All Other Loss Adjustment Expense Paid $0
Injured Person's Total Non-Economic Loss $500,000
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
Unknown
 
Updates
 
No updates found.

 

 

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

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Dr. Hani Razek Medical Malpractice Lawsuits - Court Case # 12-546-CA

Indemnity Paid: $300,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201576132
Claim Number : FP4266501
Date Submitted : 10/21/2015
 
Insurer Information
 
Insurer Name Coverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INC Primary
Insurer FEIN Professional License Number
59-6614702  
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 Hani   Razek
Insurer Type Street Address of Practice
Licensed 1717 North E. Street, Suite 333
City State Zip Code County
Pensacola FL 32501 Escambia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
FP-CL104983 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME85853 Cardiovascular Disease - 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 Santa Rosa
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Outpatient Facility  
Name of Institution Code
BAPTIST HOSPITAL 100093
Location of Institutional Injury Other Location of Institutional Injury
Special Procedure Room  
Date of Occurrence Date Reported to Insurer
7/5/2010 1/27/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Fatigue, difficulty sleeping, elevated blood pressure and dyspnea on exertion.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Consult for stress echocardiogram.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Disputed allegations of failing to properly interpret the patient's stress echocardiogram properly and alert the patient's PCP to order further diagnostic testing and treatment to prevent a fatal MI.
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
5/10/2012 12-546-CA
County Suit Filed in Date of Final Disposition
Santa Rosa 10/16/2015
Other Defendants Involved in this Claim
Langhorne Cardiology Consultants, Inc., DBA Cardiology Cons.
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 $300,000
Loss Adjust Expense Paid to Defense Counsel $14,529
All Other Loss Adjustment Expense Paid $9,565
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. ANDREW EISENBERG Medical Malpractice Lawsuits - Court Case # 14000557CAMXAX

Indemnity Paid: $250,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201679765
Claim Number : 2014517672
Date Submitted : 9/26/2016
 
Insurer Information
 
Insurer Name Coverage Type
EDCare PGPA Primary
Insurer FEIN Professional License Number
99-9999999 mm999999999999
Insurer Contact Information
Type First Name MI Last Name
Individual Daniel   Turpen
Street Address
9800 Richmond, Suite 425
City State Zip
Houston TX 77042
Phone Ext Fax E-Mail Address
(713) 914 - 3243   (713) 914 - 3250 daniel.turpen@sedgwickcms.com
 
Insured Information
 
Type First Name MI Last Name
Individual ANDREW   EISENBERG
Insurer Type Street Address of Practice
Self-Insurer 147 Explorer Drive
City State Zip Code County
Osprey FL 34229 Sarasota
Policy Number Per Claim Policy Limits Aggregate Policy Limits
HPP-EDCare 500K SIR $500,000 $500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME92155 Emergency Medicine - Including 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 Sarasota
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
SANTA ROSA MEDICAL CENTER 100124
Location of Institutional Injury Other Location of Institutional Injury
Other ER
Date of Occurrence Date Reported to Insurer
10/5/2013 3/4/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
abdominal Aortic aneurysm
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ER evaluation
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
abdominal Aortic aneurysm
Principal Injury Giving Rise To The Claim
wrongful 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
5/16/2014 14000557CAMXAX
County Suit Filed in Date of Final Disposition
Santa Rosa 7/28/2016
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
7/28/2016
 
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 $211,631
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
Risk Management review
 
Updates
 
No updates found.

 

 

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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. 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. 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. 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. John Lee Medical Malpractice Lawsuits - Court Case # 2017-CP-162

Indemnity Paid: $125,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885386
Claim Number : GC100108365a20163228
Date Submitted : 5/25/2018
 
Insurer Information
 
Insurer Name Coverage Type
CARE RISK RETENTION GROUP, INC. Primary
Insurer FEIN Professional License Number
52-2395338  
Insurer Contact Information
Type First Name MI Last Name
Individual Sarah   McIntosh
Street Address
PO Box 22989
City State Zip
Louisville KY 40252
Phone Ext Fax E-Mail Address
(502) 708 - 3103     smcintosh@rmsc.com
 
Insured Information
 
Type First Name MI Last Name
Individual John   Lee
Insurer Type Street Address of Practice
Licensed 5942 Berryhill Rd.
City State Zip Code County
Milton FL 32570 Santa Rosa
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PPL0900215 $250,000 $75,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME50043 Surgery - Obstetrics - Gynecology  

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 Santa Rosa
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
SANTA ROSA MEDICAL CENTER 100124
Location of Institutional Injury Other Location of Institutional Injury
Labor and Delivery Room  
Date of Occurrence Date Reported to Insurer
2/26/2016 5/1/2017
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Labor and delivery
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
After hospital admission to the mother the physician examined the mother and fetal monitoring strips. When the mother achieved full dilation, the delivery occurred.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient's mother had all the signs of a high risk pregnancy. The physician knew the baby would be large. An infant weighing 11 lbs 6 ozs should have been delivered by C-section not vaginally. As a result, the baby got stuck in the birth canal and was deprived of oxygen. The baby could not be resuscitated and died 2 hours later.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
1/5/2018 2017-CP-162
County Suit Filed in Date of Final Disposition
Santa Rosa 4/25/2018
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
4/27/2018
 
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 $25,994
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 $150,000 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Policy in place.
 
Updates
 
No updates found.

 

 

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

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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. JOHN M BODEN Medical Malpractice Lawsuits - Court Case # 2013 CA 001028 A

Indemnity Paid: $75,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201677494
Claim Number : 306236
Date Submitted : 3/8/2016
 
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 JOHN M BODEN
Insurer Type Street Address of Practice
Licensed 1000 West Moreno Street
City State Zip Code County
Pensacola FL 32501 Escambia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0936386 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME94719 Hospitalists  

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 Escambia
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
BAPTIST HOSPITAL 100093
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
6/28/2011 5/20/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the emergency room complaining of chest pain and was later diagnosed with an MI.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Telemetry, serial EKG's, serial cardiac enzymes, which were all normal.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Disputed allegations of failing to properly identify and address impending cardiac deterioration resulting in alleged cardiac injury.
Principal Injury Giving Rise To The Claim
Disputed allegations of decreased cardiac function.
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
9/30/2013 2013 CA 001028 A
County Suit Filed in Date of Final Disposition
Santa Rosa 2/22/2016
Other Defendants Involved in this Claim
Baptist 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
 
 
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 $16,967
All Other Loss Adjustment Expense Paid $23,449
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. John D Gary Medical Malpractice Lawsuits - Court Case # 2012-CA-1612

Indemnity Paid: $75,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201678959
Claim Number : 40258
Date Submitted : 8/23/2016
 
Insurer Information
 
Insurer Name Coverage Type
MAG MUTUAL INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
58-1449198  
Insurer Contact Information
Type Entity Name
Entity MAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
City State Zip
Orlando FL 32819
Phone Ext Fax E-Mail Address
(407) 370 - 3813   (407) 370 - 2247 ctschanz@magmutual.com
 
Insured Information
 
Type First Name MI Last Name
Individual John D Gary
Insurer Type Street Address of Practice
Licensed 1717 North E St., Ste. 222A
City State Zip Code County
Pensacola FL 32501 Escambia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1601966 06 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME91924 Pulmonary Diseases - 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
  F Santa Rosa
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
GULF BREEZE HOSPITAL 110003
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
10/9/2010 2/16/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Septic shock/hypoxia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to treat septic shock/hypoxia
Principal Injury Giving Rise To The Claim
Septic shock, ARDS, multisystem failure
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
12/6/2012 2012-CA-1612
County Suit Filed in Date of Final Disposition
Santa Rosa 7/18/2016
Other Defendants Involved in this Claim
Rao, MD, Rammohan S
Kellan, MD, David
Patterson, MD, Nathan
Dollister, MD, Michael
Riley, MD, Scott
Gore, ARNP, Angela
Wiles, MD, Ronald
Gulf Breeze Hospital
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 Decision Other
Other Dismissal
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/27/2016
 
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 $149,198
All Other Loss Adjustment Expense Paid $41,870
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $20,000 $0
Wage Loss $0 $0
Other Expenses $15,000 $997,549
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change: 8/23/2016 11:41:45 AM
Reason for Change: Report updated to reflect Court Document final disposition date of 07/18/16
 
Field Changed Former Value New Value
Date of Final Disposition 27-JUN-16 18-JUL-16

 

 

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Dr. Rammohan S Rao Medical Malpractice Lawsuits - Court Case # 2012-CA-1612

Indemnity Paid: $75,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201678961
Claim Number : 40259
Date Submitted : 8/23/2016
 
Insurer Information
 
Insurer Name Coverage Type
MAG MUTUAL INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
58-1449198  
Insurer Contact Information
Type Entity Name
Entity MAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
City State Zip
Orlando FL 32819
Phone Ext Fax E-Mail Address
(407) 370 - 3813   (407) 370 - 2247 ctschanz@magmutual.com
 
Insured Information
 
Type First Name MI Last Name
Individual Rammohan S Rao
Insurer Type Street Address of Practice
Licensed 1717 North E St. Ste. 222A
City State Zip Code County
Pensacola FL 32501 Escambia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1601966 06 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME74295 Pulmonary Diseases - 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
  F Escambia
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
GULF BREEZE HOSPITAL 110003
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
10/9/2010 2/16/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Septic shock/hypoxia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to treat septic shock/hypoxia
Principal Injury Giving Rise To The Claim
Septic shock, ARDS, multisystem failure
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
12/6/2012 2012-CA-1612
County Suit Filed in Date of Final Disposition
Santa Rosa 7/18/2016
Other Defendants Involved in this Claim
Gary, MD, John D
Kellan, MD, David
Patterson, MD, Nathan
Dolister, MD, Michael
Riley, MD, Scott
Gore, ARNP, Angela
Wiles, MD, Ronald
Gulf Breeze Hospital
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 Decision Other
Other Dismissal
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/27/2016
 
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 $134,653
All Other Loss Adjustment Expense Paid $31,535
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $20,000 $0
Wage Loss $0 $0
Other Expenses $15,000 $997,549
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change: 8/23/2016 11:49:51 AM
Reason for Change: Report updated to reflect Court Document final disposition date of 07/18/16
 
Field Changed Former Value New Value
Date of Final Disposition 27-JUN-16 18-JUL-16

 

 

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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. Noel L Spurlock Medical Malpractice Lawsuits - Court Case # 2014-CA 000768

Indemnity Paid: $24,500.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201781824
Claim Number : 2192219
Date Submitted : 4/14/2017
 
Insurer Information
 
Insurer Name Coverage Type
THE CINCINNATI INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
31-0542366  
Insurer Contact Information
Type First Name MI Last Name
Individual Heather N Hartman
Street Address
6200 South Gilmore Road
City State Zip
Fairfield OH 45014
Phone Ext Fax E-Mail Address
(513) 603 - 5846   (513) 371 - 7028 Heather_Hartman@CINFIN.COm
 
Insured Information
 
Type First Name MI Last Name
Individual Noel L Spurlock
Insurer Type Street Address of Practice
Licensed 4041 Hwy 90
City State Zip Code County
Pace FL 32571 Santa Rosa
Policy Number Per Claim Policy Limits Aggregate Policy Limits
CPP 1083179 $1,000,000 $2,000,000
Profession or Business Other Profession or Business
Dentistry  
License Number Specialty Code & Classification Certification Number
DN6463 Dental General Practice - NOC  

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 Santa Rosa
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
   
Date of Occurrence Date Reported to Insurer
1/23/2012 4/2/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
While insd extracting clmt's 3rd molar, a burr tool bit broke off in clmt's mouth. Clmt is alleging insd insd breached the ordinary standard of care surrounding the procedure.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
While insd extracting clmt's 3rd molar, a burr tool bit broke off in clmt's mouth. Clmt is alleging insd insd breached the ordinary standard of care surrounding the procedure.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
While insd extracting clmt's 3rd molar, a burr tool bit broke off in clmt's mouth. Clmt is alleging insd insd breached the ordinary standard of care surrounding the procedure.
Severity Of Injury
Temporary: Slight - Lacerations, contusions, minor scars, rash. No delay.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
8/18/2014 2014-CA 000768
County Suit Filed in Date of Final Disposition
Santa Rosa 4/13/2017
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed).
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
4/13/2017
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $24,500
Loss Adjust Expense Paid to Defense Counsel $20,080
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
None given
 
Updates
 
No updates found.

 

 

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

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Dr. Heather Amos Medical Malpractice Lawsuits - Court Case # 2016-202-CA

Indemnity Paid: $20,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201884163
Claim Number : 156681-2
Date Submitted : 1/23/2018
 
Insurer Information
 
Insurer Name Coverage Type
HEALTH CARE INDEMNITY, INC. Primary
Insurer FEIN Professional License Number
61-0904881  
Insurer Contact Information
Type First Name MI Last Name
Individual Teresa   Ross
Street Address
One Park Plaza P.O. Box 555
City State Zip
Nashville TN 37202
Phone Ext Fax E-Mail Address
(615) 344 - 5804     Teresa.Ross@HCAHealthcare.com
 
Insured Information
 
Type First Name MI Last Name
Individual Heather   Amos
Insurer Type Street Address of Practice
Licensed 6488 N U.S. Highway 41
City State Zip Code County
Apollo Beach FL 33572 Hillsborough
Policy Number Per Claim Policy Limits Aggregate Policy Limits
HCI-10113 $250,000 $750,000
Profession or Business Other Profession or Business
Osteopathic Physician  
License Number Specialty Code & Classification Certification Number
OS11970 Family Physicians or General Practitioners - No Surgery 01

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 Santa Rosa
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
9/16/2013 10/1/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Onychomycosis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient developed DRESS due to Lamisil reaction. Patient developed acute kidney failure requiring dialysis & was acutely ill.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Acute kidney failure, acute interstitial nephritis.
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
3/14/2016 2016-202-CA
County Suit Filed in Date of Final Disposition
Santa Rosa 1/9/2018
Other Defendants Involved in this Claim
Novartis Pharmaceuticals Corporation
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
1/8/2018
 
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 $16,919
All Other Loss Adjustment Expense Paid $1,760
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $79,999 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Review of policies and procedures.
 
Updates
 
No updates found.

 

 

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

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Dr. Barry Callahan Medical Malpractice Lawsuits - Court Case # 2012 CA 1640

Indemnity Paid: $20,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201472243
Claim Number : 12-0165-A-10
Date Submitted : 10/7/2014
 
Insurer Information
 
Insurer Name Coverage Type
FD INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
20-3704679  
Insurer Contact Information
Type First Name MI Last Name
Individual Linda D Collins
Street Address
4651 Salisbury Road, Suite 410
City State Zip
Jacksonville FL 32256
Phone Ext Fax E-Mail Address
(904) 296 - 2887 214 (904) 296 - 1245 lcollins@fldic.com
 
Insured Information
 
Type First Name MI Last Name
Individual Barry   Callahan
Insurer Type Street Address of Practice
Licensed 1040 Gulf Breeze Parkway, Suite 204
City State Zip Code County
Gulf Breeze FL 32561 Santa Rosa
Policy Number Per Claim Policy Limits Aggregate Policy Limits
MS000559 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME102420 Surgery - Orthopedic  

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 Santa Rosa
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Outpatient Facility Andrews Institute Surgery Center
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Operating Suite  
Date of Occurrence Date Reported to Insurer
7/20/2010 8/13/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the insured following a bicycle accident, which resulted in an ulnar side right wrist injury.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right wrist diagnostic arthroscopy, synovectomy and debridement of central TFCC tear.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None made.
Principal Injury Giving Rise To The Claim
Alleged insured left a foreign body in patient's wrist causing wrist problems.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
12/7/2012 2012 CA 1640
County Suit Filed in Date of Final Disposition
Santa Rosa 9/10/2014
Other Defendants Involved in this Claim
Depuy Mitek, 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
9/10/2014
 
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 $42,797
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
Circumstances of this case have been discussed with the insured and Risk Management was notified.
 
Updates
 
No updates found.

 

 

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