Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Department File Number : | M201783637 |
Claim Number : | SM272558 |
Date Submitted : | 11/14/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EVANSTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2950161 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | CRYSTAL | L | ALSTONBAYTON | ||
Street Address | |||||
4600 COX ROAD | |||||
City | State | Zip | |||
GLEN ALLEN | VA | 23060 | |||
Phone | Ext | Fax | E-Mail Address | ||
(804) 864 - 3731 | (855) 662 - 7535 | CALSTONBAYTON@MARKELCORP.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | FRANTZ | SIMEON | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 4960 SW 72ND AVE; STE 400 | ||||
City | State | Zip Code | County | ||
MIAMI | FL | 33155 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SM897682 | $1,000,000 | $5,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | MEDICAL DENTAL BEHAVIORAL SERVICES TO CORRECTIONAL FACILITY | ||||
License Number | Specialty Code & Classification | Certification Number | |||
ACN323 |
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 | ||||
Other Location | SARASOTA COUNTY JAIL CELL | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | INMATE CELL | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/17/2014 | 5/27/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
CLMT ALLEGES FAILURE TO TREAT BACK CONDITION RESULTING IN L2-3 LAMINECTOMY AND MICRODISKECTOMY | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
DELAYED DIAGNOSIS S/P PERMANENT NEUROLOGICAL INJURIES INCLUDING BUT NOT LIMITED TO BLADDER DYSFUNCTION LOSS OF SENSATION IN HIS SADDLE AREA, INABILITY TO OBTAIN AN ERECTION SEVERE PAIN AND DIMINISHED STRENGTH AND MOTOR FUNCTION IN HIS LEGS | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO MISDIAGNOSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
CLMT PRESENT TO JAIL WITH HISTORY OF STENOSIS AND DEGENERATIVE DISK DISEASE IN HIS LOWER BACK. WALKED WITH NO ASSISTANCE OTHER THAN KNEE BRACE. ALLEGES RE-INJ AROUND 04172014 AND CAME UNDER ARMOR'S CARE. ALLEGES SHOOTING PAINS IN LEGS AND REQ'D WHEELCHAIR D/T INABILITY TO WALK. ALLEGES PAIN PERSISTED AND HE WAS REFUSED REQUEST TO GO TO ER. ON 04112014 HE WAS PUT IN MEDICAL UNITY WITH FULL BRACE NOTING STRESS FRACTURE. RELEASED TO GEN POP ON 04142014. GIVEN LOWER BUNK ADVISED NO WEIGHT BEARING FOR 5-6 WEEKS. ALLEGES CONDITION WORSENED UPON RELEASE ON 04232014 HE WAS RELEASED FROM JAIL. HE CALLED 911, WAS TRANSPORTED FROM JAIL. REMAINED IN HOSPITAL UNTIL RELEASED ON 06012014. ALLEGES DUE TO DELAYED DIAGNOSIS, HE NOW HAS PERMANENT INJURY. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/17/2015 | 2015CA000872NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 4/30/2016 | ||||
Other Defendants Involved in this Claim | |||||
ENNIS, LAURA A ATKINSON, JAMES E BURK, LISA B CARSTENS, SONJA K |
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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 | |||||
4/30/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $1,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $60,568 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $49,328 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $50,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
NONE |
Updates | |
No updates found. |
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M201886680 |
Claim Number : | EMC-FL-15-325806-1 |
Date Submitted : | 10/11/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EmCare Holdings, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
75-173235 | SI | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
1900 W. LOOP S., STE. 1500 | |||||
City | State | Zip | |||
Houston | TX | 77027 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JAN | BROWN | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 8330 LAKEWOOD RANCH RD | ||||
City | State | Zip Code | County | ||
BRADENTON | FL | 34202 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HAZ1040025381-13 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME113488 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Sarasota | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | DOCTORS HOSPITAL OF SARASOTA | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
10/10/2013 | 12/18/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
CEREBRAL EMBOLUS | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
SEEN IN ER | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
ALLEGED FAILURE TO TIMELY REQUEST CONSULT | |||||
Principal Injury Giving Rise To The Claim | |||||
WORSENING CONDITION | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/30/2016 | 2016-CA-003356 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 9/20/2018 | ||||
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 | |||||
9/20/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $750,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
UNKNOWN |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201677100 |
Claim Number : | 286831 |
Date Submitted : | 2/12/2016 |
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 | AUDRA | M | FLOYD | ||
Street Address | |||||
13450 WEST SUNRISE BLVD | |||||
City | State | Zip | |||
SUNRISE | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | 3111 | (866) 636 - 5421 | afloyd@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Richard | W | Golub | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4800 Peregrine Point Circle West | ||||
City | State | Zip Code | County | ||
Sarasota | FL | 34231 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0058096 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME85935 | Surgery - Colon and Rectal |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/11/2009 | 6/1/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to ER with cholelithiasis and acute cholecystitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insured performed cholecystectomy. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Bilateral below the knee amputations. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/6/2012 | 2011CA 8370NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 2/8/2016 | ||||
Other Defendants Involved in this Claim | |||||
EMCARE, Inc. Federer, MD, Debra H Letts, MD, Brian P McDowell, PA, Mitchell C Sarasota Doctors Hospital, Inc. |
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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 | |||||
2/8/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $750,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $152,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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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.
This page is not displaying certain sensitive information.
Department File Number : | M201678039 |
Claim Number : | EMC-AO-11XS-271398 |
Date Submitted : | 4/26/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EmCare Holdings, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
75-173235 | SI | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
1900 W. LOOP S., STE. 1500 | |||||
City | State | Zip | |||
Houston | TX | 77027 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MITCHELL | MCDOWELL | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 5731 BEE RIDGE ROAD | ||||
City | State | Zip Code | County | ||
SARASOTA | FL | 34233 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EMC-2011-Excess | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | PHYSICIANS ASSISTANT | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9102385 |
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 | ||||
Other Hospital/Institution | DOCTORS HOSPITAL OF SARASOTA | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/11/2009 | 8/19/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
UPPER RIGHT QUADRANT PAIN | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
SEEN IN ER. US WAS POSITIVE FOR DILATED GALLBLADDER. GIVEN DILAUDID AND PATIENT IMPROVED. DISCHARGED | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO MISDIAGNOSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
ACUTE CHOLECYSTITIS AND SEPSIS R/I BKA OF BOTH LEGS. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/19/2011 | 2011CA8370NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 3/28/2016 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
2/9/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $625,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
UNKNOWN |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201885415 |
Claim Number : | 332576 |
Date Submitted : | 5/31/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Donald | L | Erb | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 650 Cattleridge Blvd. Suite 201 | ||||
City | State | Zip Code | County | ||
Sarasota | FL | 34232 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0967036 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS7114 | Anesthesiology - Pain Management |
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 | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
SARASOTA MEMORIAL HOSPITAL | 100087 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/9/2013 | 8/1/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought treatment for chronic low back pain. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient underwent epidural steroid injections. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
It is alleged that the insured inappropriately and negligently performed epidural steroid injection resulting in neurologic deficits including paraplegia and paraparesia in this 60 year old male. | |||||
Principal Injury Giving Rise To The Claim | |||||
Neurologic deficits including alleged paraplegia and paraparesia. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/23/2015 | 2016CA6323 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 5/2/2018 | ||||
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 | |||||
5/2/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $600,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $4,817 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $87,826 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
|
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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. |
This page is not displaying certain sensitive information.
Department File Number : | M201887062 |
Claim Number : | 322338 |
Date Submitted : | 11/18/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christopher | M | Donato | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 2509 West Crest Avenue Suite 1 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33614 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0948706 | $2,000,000 | $5,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN14844 | Dental General Practice - NOC |
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 | ||||
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 | ||||
7/18/2014 | 9/8/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Need for restoration of dental implant for tooth #19. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Taking of impression to manufacture crown for dental implant. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was none. | |||||
Principal Injury Giving Rise To The Claim | |||||
32 year old patient with spina bifida, VP shunt and Crohn's Disease status post colectomy and colostomy required surgery to remove a hex driver that he swallowed after it was inadvertently dropped onto his tongue. The object became stuck at an area of a pre-existing stricture in the small bowel. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/5/2016 | 2016-CA-4893NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 10/23/2018 | ||||
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 | |||||
10/23/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $575,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $51,410 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $18,455 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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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. |
Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M201987778 |
Claim Number : | 354384 |
Date Submitted : | 2/3/2019 |
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 | Ryan | L | Baker | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 943 South Beneva Road Suite 306 | ||||
City | State | Zip Code | County | ||
Sarasota | FL | 34232 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0058096 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME113210 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Sarasota | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SARASOTA MEMORIAL HOSPITAL | 100087 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/24/2016 | 4/3/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Acute anemia and aspiration pneumonia; ultimately a bleeding duodenal ulcer was discovered. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged failure to diagnose and treat acute anemia and a bleeding duodenal ulcer and failure to timely order a GI consult. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/8/2017 | 2017CA003892NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 1/16/2019 | ||||
Other Defendants Involved in this Claim | |||||
Intercoastal Medical Group, Inc. Thomas, MD, Jessica M Baker, MD, Ryan L Sarasota Memorial Health Care System |
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Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/16/2019 |
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 | $21,461 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,921 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $500,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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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. |
Department File Number : | M201678760 |
Claim Number : | 326221 |
Date Submitted : | 6/17/2016 |
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 | LEONIE | M | VAN PASSEL | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 943 SOUTH BENEVA ROAD, SUITE 306 | ||||
City | State | Zip Code | County | ||
SARASOTA | FL | 34239 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0058096 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME94413 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Sarasota | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | SARASOTA DOCTORS HOSPITAL | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/5/2014 | 1/16/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
STROKE. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
ALLEGED FAILURE TO ORDER AND ADMINISTER TPA. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
NEUROLOGICAL INJURIES. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/14/2016 | 2015CA002493NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 5/18/2016 | ||||
Other Defendants Involved in this Claim | |||||
CANTERO, JULIO SARASOTA DOCTORS HOSPITAL NEUROWORKS INTERCOASTAL MEDICAL GROUP |
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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 | $500,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $36,367 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $13,066 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $1,000,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims.
This page is not displaying certain sensitive information.
Department File Number : | M201885036 |
Claim Number : | 356675 |
Date Submitted : | 4/13/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Thomas | Reed | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2001 Webber Street | ||||
City | State | Zip Code | County | ||
Sarasota | FL | 34239 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0948843 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62026 | Pathology - All Other |
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 | ||||
Other Location | Sarapath Diagnostics | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
2/26/2015 | 6/1/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Analysis of biopsy of lesion of the floor of the mouth, under the tongue, which the patient had postponed for over 2 years. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Pathology interpretation of lesion as benign. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Lesion of malignant. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient underwent chemotherapy but had recurrence with metastasis and died. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/5/2017 | 2017-CA-4409 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 4/10/2018 | ||||
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 | |||||
4/10/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $475,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,638 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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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. |
This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M201885292 |
Claim Number : | 00444909 |
Date Submitted : | 5/14/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MT. HAWLEY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
37-1072999 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Brett | Cleveland | |||
Street Address | |||||
9025 N. Lindbergh Dr | |||||
City | State | Zip | |||
Peoria | IL | 61615 | |||
Phone | Ext | Fax | E-Mail Address | ||
(309) 692 - 1000 | 5214 | brett.cleveland@rlicorp.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Langdon | G | Morrison | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 240 the Rialto | ||||
City | State | Zip Code | County | ||
Venice | FL | 34233 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MME0000051 | $500,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME112883 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Sarasota | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Venice Regional Medical Center | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/16/2016 | 9/7/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
obstructing stone with evidence of infection on urinalysis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Failure to properly treat resulting in amputation of toes | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
amputation of all toes on left foot, behind the knuckles, and the tips of 3 toes on the right foot | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/31/2018 | 2018-CA-000550-NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 5/11/2018 | ||||
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 Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
5/11/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $471,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $8,873 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $10,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims.
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |