Medical Malpractice Cases

Medical Malpractice Cases In Volusia County Florida

Dr. Paul Phillips Medical Malpractice Lawsuits - Court Case # 2007-11030-CIDL

Indemnity Paid: $7,239,248.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201161145
Claim Number :35185-01
Date Submitted :7/26/2011
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPaul Phillips
Insurer TypeStreet Address of Practice
Licensed5734 Vintage View Avenue
CityStateZip CodeCounty
LakelandFL33813Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
26466$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME71554Family Physicians or General Practitioners - No Surgery80239

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
2/15/20041/19/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Failure to refer patient to cardiologist for chest pain.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Cardiac arrest, comatose state.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
6/12/20072007-11030-CIDL
County Suit Filed inDate of Final Disposition
Volusia7/5/2011
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
After appeal.
Final Method of Claim Disposition
Disposed of by Court
Court DecisionOther
Judgment for the plaintiff after appeal ... 
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/5/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$7,239,248
Loss Adjust Expense Paid to Defense Counsel$367,814
All Other Loss Adjustment Expense Paid$248,141
Injured Person's Total Non-Economic Loss$7,239,248
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. BETTY O AGBEDE Medical Malpractice Lawsuits - Court Case # 2017-30063-CICI

Indemnity Paid: $2,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201886072
Claim Number : 348962
Date Submitted : 8/6/2018
 
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 BETTY O AGBEDE
Insurer Type Street Address of Practice
Licensed 298 S. Yonge Street
City State Zip Code County
Ormond Beach FL 32174 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0962003 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME111451 Emergency Medicine - No Major Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution Florida Hospital Deland
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Emergency Room
Date of Occurrence Date Reported to Insurer
4/6/2015 10/4/2016
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented with complaints of severe low back pain. The patient had a herniated disk at L5-S1.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No procedure rendered.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis of disk herniation L5-S1.
Principal Injury Giving Rise To The Claim
Urinary and bowel incontinence.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
1/12/2017 2017-30063-CICI
County Suit Filed in Date of Final Disposition
Volusia 7/18/2018
Other Defendants Involved in this Claim
Florida Hospital Deland
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 $2,000,000
Loss Adjust Expense Paid to Defense Counsel $204,291
All Other Loss Adjustment Expense Paid $170,595
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. JEFFERY S REINERTSEN Medical Malpractice Lawsuits - Court Case # 2016-10445-CIDL

Indemnity Paid: $1,950,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201782020
Claim Number : 331610
Date Submitted : 11/15/2017
 
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 JEFFERY S REINERTSEN
Insurer Type Street Address of Practice
Licensed 809 North Stone Street
City State Zip Code County
Deland FL 32720 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0918371 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME57770 Pediatrics - 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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution Florida Hospital Deland
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
12/13/2014 7/6/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient seen at hospital after earlier suffering an anoxic brain injury during delivery at a birthing center. The child had been transported to the ED at Florida Hospital Deland and was admitted.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Traumatic delivery.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Brain damage.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
4/13/2016 2016-10445-CIDL
County Suit Filed in Date of Final Disposition
Volusia 4/21/2017
Other Defendants Involved in this Claim
Florida Hospital Deland
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
4/21/2017
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $1,950,000
Loss Adjust Expense Paid to Defense Counsel $63,282
All Other Loss Adjustment Expense Paid $49,332
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
 
Date of Change: 11/15/2017 3:11:58 PM
Reason for Change: Language change to description.
 
Field Changed Former Value New Value
Final Diagnosis The patient suffered an anoxic brain injury during delivery at a birthing center. The child was transported to the ED at Florida Hospital Deland. Patient seen at hospital after earlier suffering an anoxic brain injury during delivery at a birthing center. The child had been transported to the ED at Florida Hospital Deland and was admitted.

 

 

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Dr. BOYD HATTON Medical Malpractice Lawsuits - Court Case # 2016-30386 CICI

Indemnity Paid: $1,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201680504
Claim Number : PLFHMC079294
Date Submitted : 11/30/2016
 
Insurer Information
 
Insurer Name Coverage Type
Florida Physicians Medical Group Primary
Insurer FEIN Professional License Number
59-3214635 800014080
Insurer Contact Information
Type First Name MI Last Name
Individual Matthew   Evans
Street Address
900 Hope Way
City State Zip
Altamonte Springs FL 32712
Phone Ext Fax E-Mail Address
(407) 357 - 2272     matt.evans@ahss.org
 
Insured Information
 
Type First Name MI Last Name
Individual BOYD   HATTON
Insurer Type Street Address of Practice
Self-Insurer 301 Memorial Medical Pkwy
City State Zip Code County
Daytona Beach FL 32117 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
8258 - 2014 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME97372 Radiology - Diagnostic - 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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
MEMORIAL HOSPITAL - ORMOND BEACH 100169
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
6/26/2014 8/19/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
ED presentation with neck and upper back pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ED workup that included CT scan(s) of the cervical, thoracic, and lumbar spine; and pain medications.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Involved was the alleged negligent failure of the physician to have appreciated the severity of patient's signs and symptoms and appropriately interpreted imaging studies that demonstrated acute spinal cord compression as a result of an epidural abscess; which resulted inpatient's ultimate incomplete quadriplegia.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
3/28/2016 2016-30386 CICI
County Suit Filed in Date of Final Disposition
Volusia 10/18/2016
Other Defendants Involved in this Claim
Florida Hospital Memorial Medical Center
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/18/2016
 
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 $0
All Other Loss Adjustment Expense Paid $0
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
n/a
 
Updates
 
No updates found.

 

 

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

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Dr. Franklin Dana Medical Malpractice Lawsuits - Court Case # 2014-11930-CIDL

Indemnity Paid: $1,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201574935
Claim Number : 48959/48960
Date Submitted : 6/12/2015
 
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 Franklin   Dana
Insurer Type Street Address of Practice
Licensed 3685 John Anderson Dr.
City State Zip Code County
Ormond Beach FL 32176 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1602223 08 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME73080 Radiology - interventional  

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 Volusia
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
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
8/18/2010 6/11/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lung cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly interpret chest x-ray
Principal Injury Giving Rise To The Claim
Lung cancer
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
10/8/2014 2014-11930-CIDL
County Suit Filed in Date of Final Disposition
Volusia 5/27/2015
Other Defendants Involved in this Claim
Florida Hospital DeLand
Central Florida Medical Imaging
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
5/27/2015
 
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 $15,110
All Other Loss Adjustment Expense Paid $4,497
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $350,000 $0
Wage Loss $0 $75,000
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. David L Williams Medical Malpractice Lawsuits - Court Case # 2005 32022 CICI

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640805
Claim Number :A05-32583-05
Date Submitted :5/25/2006
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualCheriMMontague
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423043(904) 358 - 6728montague@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualDavidLWilliams
Insurer TypeStreet Address of Practice
Licensed1340 Ridgewood Avenue
CityStateZip CodeCounty
Daytona BeachFL32117Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
38525$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME35686Cardiovascular Disease - No Surgery80422

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MVolusia
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
1/29/20055/31/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Loss of consciousness while playing tennis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Cardiac workup including EKG, enzyme studies.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
After workup, it was concluded by Dr. Williams that in all probability, the patient had suffered a vasovagal incident resulting in loss of consciousness.
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
11/28/20052005 32022 CICI
County Suit Filed inDate of Final Disposition
Volusia5/3/2006
Other Defendants Involved in this Claim
Florida Health Care Plans, Inc.
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/3/2006
 
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$7,498
All Other Loss Adjustment Expense Paid$9,152
Injured Person's Total Non-Economic Loss$1,000,000
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. YOUSSEF W GUERGUES Medical Malpractice Lawsuits - Court Case # 2005 30343

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200746562
Claim Number :274299-1
Date Submitted :2/4/2009
 
Insurer Information
 
Insurer NameCoverage Type
MEDICAL PROTECTIVE COMPANY (THE)Primary
Insurer FEINProfessional License Number
35-0506406 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualMary Osborn
Street Address
5814 Reed Rd
CityStateZip
Fort WayneIN46835
PhoneExtFaxE-Mail Address
(800) 463 - 37766604(260) 486 - 0785Mary.Osborn@medpro.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualYOUSSEFWGUERGUES
Insurer TypeStreet Address of Practice
Licensed53 N OLD KINGS RD STE C
CityStateZip CodeCounty
ORMOND BEACHFL32174-5176Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
682327$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME73221Anesthesiology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
11/3/20031/15/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
CERVICAL DEGENERATIVE ARTHRITIS
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
STEROID INJECTIONS
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
FAILURE TO PROPERLY TREAT
Principal Injury Giving Rise To The Claim
CARDIO-RESIPRATORY ARREST
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
2/18/20052005 30343
County Suit Filed inDate of Final Disposition
Volusia7/31/2007
Other Defendants Involved in this Claim
MALIK, VINOD K
PRC ASSOCIATES
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
8/10/2007
 
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$56,689
All Other Loss Adjustment Expense Paid$24,984
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
n/a
 
Updates
 
 
Date of Change:2/4/2009 10:05:18 AM
Reason for Change:Updated the policy number and ALE
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid2509624984
Insured Policy Number274299682327
Amount of Loss Adjustment Expense Paid to Defense Counsel4902256689

 

 

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Dr. Paul C Marton Medical Malpractice Lawsuits - Court Case # 2013-12736-CIDL

Indemnity Paid: $875,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201573367
Claim Number : FP4361701
Date Submitted : 2/4/2015
 
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 Paul C Marton
Insurer Type Street Address of Practice
Licensed 290 North Kepler Road
City State Zip Code County
DeLand FL 32724 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
FP-CL099415 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME40358 Family Physicians or General Practitioners - 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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Location Florida Hosp - Fish Memorial Orange City
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Other Emergency Room
Date of Occurrence Date Reported to Insurer
6/1/2012 10/2/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Right flank pain with fever. Suspected kidney stone.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Medical management included antibiotic therapy.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Below knee amputation.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
9/30/2013 2013-12736-CIDL
County Suit Filed in Date of Final Disposition
Volusia 1/27/2015
Other Defendants Involved in this Claim
Emegency Medical Professionals, PA
Florida Hospital - Fish Memorial
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 $875,000
Loss Adjust Expense Paid to Defense Counsel $19,686
All Other Loss Adjustment Expense Paid $16,222
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate
 
Updates
 
No updates found.

 

 

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

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Dr. Rodolfo E Chirinos Medical Malpractice Lawsuits - Court Case # 642016CA011149

Indemnity Paid: $862,500.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201782109
Claim Number : 1032258-01
Date Submitted : 2/9/2018
 
Insurer Information
 
Insurer Name Coverage Type
MEDICAL PROTECTIVE COMPANY (THE) Primary
Insurer FEIN Professional License Number
35-0506406  
Insurer Contact Information
Type First Name MI Last Name
Individual Lynn Louthan
Street Address
5814 Reed Road
City State Zip
Ft Wayne IN 46835
Phone Ext Fax E-Mail Address
(260) 486 - 0778     reportaclaim@medpro.com
 
Insured Information
 
Type First Name MI Last Name
Individual Rodolfo E Chirinos
Insurer Type Street Address of Practice
Licensed 519 N Dixie Fwy
City State Zip Code County
New Smyrna Beach FL 32168 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
783532 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME113756 Dermatology - 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 Volusia
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
12/18/2013 3/11/2016
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lesion on left lower back
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
skin assessment, clinical photos taken
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Misdiagnosis of benign nevus spilus, failure to biopsy lesion
Principal Injury Giving Rise To The Claim
Metastatic melanoma
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
7/15/2016 642016CA011149
County Suit Filed in Date of Final Disposition
Volusia 5/8/2017
Other Defendants Involved in this Claim
MID FLORIDA DERMATOLOGY ASSOCIATES 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 Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/8/2017
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $862,500
Loss Adjust Expense Paid to Defense Counsel $25,719
All Other Loss Adjustment Expense Paid $8,033
Injured Person's Total Non-Economic Loss $637,500
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
n/a
 
Updates
 
 
Date of Change: 8/23/2017 3:09:35 PM
Reason for Change: updated patient address
 
Field Changed Former Value New Value
Injured Person Address Street 1720 Voctory Palm Dr 1720 Victory Palm Dr
 
Date of Change: 8/25/2017 1:17:06 PM
Reason for Change: ALE UPDATE 8/25/2017
 
Field Changed Former Value New Value
Amount of Loss Adjustment Expense Paid to Defense Counsel 23341 25682
All Other Loss Adjustment Expense Paid 6518 8032
 
Date of Change: 2/9/2018 2:44:28 PM
Reason for Change: ALE UPDATE 2/9/2018
 
Field Changed Former Value New Value
Amount of Loss Adjustment Expense Paid to Defense Counsel 25682 25719
All Other Loss Adjustment Expense Paid 8032 8033

 

 

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Dr. Hassan Zulfiqar Medical Malpractice Lawsuits - Court Case # 2009-33994 CICI

Indemnity Paid: $837,500.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201160040
Claim Number :38268-01
Date Submitted :3/2/2011
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualHassan Zulfiqar
Insurer TypeStreet Address of Practice
Licensed1340 Ridgewood Avenue
CityStateZip CodeCounty
Daytona BeachFL32117Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
98490$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME78417Gastroenterology - Minor Surgery80274

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
1/18/20082/5/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Stomach discomfort and acid reflux.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Use of phospho-soda in light of abnormal kidney lab results and improper timing of phospho-soda dosages.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Loss of both kidneys.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/12/20092009-33994 CICI
County Suit Filed inDate of Final Disposition
Volusia2/10/2011
Other Defendants Involved in this Claim
Florida HealthCare Plans
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
2/10/2011
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$837,500
Loss Adjust Expense Paid to Defense Counsel$19,391
All Other Loss Adjustment Expense Paid$12,007
Injured Person's Total Non-Economic Loss$837,500
Deductible$25,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
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. GORDON FORBES Medical Malpractice Lawsuits - Court Case # 2008-34016-CICI

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201161014
Claim Number :EMC-FLXS-08XS-110181
Date Submitted :7/11/2011
 
Insurer Information
 
Insurer NameCoverage Type
EmCare, Inc. as Self Insured CarrierPrimary
Insurer FEINProfessional License Number
75-1732351 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualKathy Stockton
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 2404 (713) 722 - 1603kathy_stockton@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGORDON FORBES
Insurer TypeStreet Address of Practice
Self-Insurer721 S. PENINSULA DRIVE
CityStateZip CodeCounty
DAYTONA BEACHFL32118Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
EMC-2008-Excess$750,000$2,250,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME93951Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
FLORIDA HOSPITAL (ORLANDO)100007
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
2/3/20074/3/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
ABSCESS ON GROIN SPREADING TO HIP
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
PATIENT WAS GIVEN PAIN MEDICATION AND ANTIBIOTICS AND TOLD TO F/U WITH A COLORECTAL SURGEON
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
CELLULITIS AND ABSCESS OF THE TRUNK
Principal Injury Giving Rise To The Claim
NECROTIZING FASCIITIS
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/22/20102008-34016-CICI
County Suit Filed inDate of Final Disposition
Volusia6/26/2011
Other Defendants Involved in this Claim
 
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
OtherSETTLED BY PARTIES
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
4/6/2011
 
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$2,383
All Other Loss Adjustment Expense Paid$7,099
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. BRENT D SCHLAPPER Medical Malpractice Lawsuits - Court Case # 2004 1035 CIDL 1

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643385
Claim Number :83008537
Date Submitted :12/6/2006
 
Insurer Information
 
Insurer NameCoverage Type
TRUCK INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
95-2575892 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualLaurieRSchwartz
Street Address
12424 Wilshire Blvd., 9th Flr.
CityStateZip
Los AngelesCA90025
PhoneExtFaxE-Mail Address
(310) 696 - 0286 (310) 979 - 4930lschwartz@litneutral.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualBRENTDSCHLAPPER
Insurer TypeStreet Address of Practice
Licensed1015 N. Stone Street, Ste A
CityStateZip CodeCounty
DelandFL32720Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0118067660000$1,000,000$1,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS4023Family Physicians or General Practitioners - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL-WEST VOLUSIA100045
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/13/20029/5/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Pt contacted physician to obtain clearance for a laproscopic cholecystectomy
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
laproscopic cholecystectomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis occured
Principal Injury Giving Rise To The Claim
Massive stroke with total left-sided paralysis.Pt is presently in a vegatative state in a nursing home.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/18/20042004 1035 CIDL 1
County Suit Filed inDate of Final Disposition
Volusia11/7/2006
Other Defendants Involved in this Claim
Arroyo, MD, PedroJ
Pedro Arroyo, MD, PA
Triplett, ARNP, Sylvia
Family Practice of West Volusia, PA
Spore, MD, Stephen S
Willis, MD, Michael D
Memorial Hospital West Volusia, Inc., d/b/a Florida Hospital
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/1/2006
 
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$62,775
All Other Loss Adjustment Expense Paid$33,249
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. hARJOT KAHLON Medical Malpractice Lawsuits - Court Case # 2006 31648 CICI

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200851273
Claim Number :EMC-FLXS-06-75745
Date Submitted :11/4/2008
 
Insurer Information
 
Insurer NameCoverage Type
CONTINENTAL CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
36-2114545 
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
IndividualhARJOT KAHLON
Insurer TypeStreet Address of Practice
Licensed3 Deepwoods Way
CityStateZip CodeCounty
Ormond BeachFL32174Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HAZ1040025381-4$750,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME87758Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
MEMORIAL HOSPITAL - ORMOND BEACH100169
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
8/24/20055/18/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Respiratory distress
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in treating respiratory distress
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Delay in treatment
Principal Injury Giving Rise To The Claim
Anoxic brain injury
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/17/20062006 31648 CICI
County Suit Filed inDate of Final Disposition
Volusia10/30/2008
Other Defendants Involved in this Claim
Florida Hospital Ormond Beach
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
8/18/2008
 
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$44,101
All Other Loss Adjustment Expense Paid$4,717
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. Nitin J Parikh Medical Malpractice Lawsuits - Court Case # 2002 11766 CIDL

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200639609
Claim Number :83-008348
Date Submitted :2/21/2006
 
Insurer Information
 
Insurer NameCoverage Type
TRUCK INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
95-2575892 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualHeidi Tam
Street Address
4680 Wilshire Blvd., Sixth Floor
CityStateZip
Los AngelesCA90010
PhoneExtFaxE-Mail Address
(323) 930 - 7078  heidi.tam@farmersinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualNitinJParikh
Insurer TypeStreet Address of Practice
Licensed1061 Medical Center Drive., # 103
CityStateZip CodeCounty
Orange CityFL32763Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
011808283-0000$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Chiropractic Physician 
License NumberSpecialty Code & ClassificationCertification Number
ME60089Gastroenterology - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
VOLUSIA MEDICAL CENTER100072
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
9/6/20017/2/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
A gallbladder ultrasound revealed gallstones & an enlarged common bile duct.The insured performed an ERCP, a normal pancreatogram was noted with no grooves seen.Dr. Parikh concluded that the common bile duct was giving dilation appearance because of s cystic duct was wrapping around it, but no stones were seen.Dr. Parikh recommended a surgical consultation to address the patient's gallblader.Patient underwent exploratory laparotomy and cholecystectomy and hemorrahagic pancreatitis was found.Patient expired as a result of exacerbated pancreatitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Endoscopic retrograde cholangiopancreatography (ERCP) patient developed severe hemorrhagic pancreatitis resulting in her demise.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Plaintiff alleges that the patient's pancreatitis was exacerbated by an unnecessary ERCP performed by the insured.As a result the patient's condition deteriorated and she subsequently died 1-1/2 weeks later.
Principal Injury Giving Rise To The Claim
Wrongful Death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/18/20022002 11766 CIDL
County Suit Filed inDate of Final Disposition
Volusia10/6/2004
Other Defendants Involved in this Claim
Capulung, Rene A
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/8/2004
 
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$750,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$6,074$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
None.The insured had no liability in this matter.It was the surgical procedure that caused a worsening of the pancreatitis which casued or contributed patient's death.
 
Updates
 
No updates found.

 

 

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Dr. Nitin J Parikh Medical Malpractice Lawsuits - Court Case # 2002 11766 cidl

Indemnity Paid: $750,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200639808
Claim Number :83-008348
Date Submitted :3/7/2006
 
Insurer Information
 
Insurer NameCoverage Type
TRUCK INSURANCE EXCHANGEPrimary
Insurer FEINProfessional License Number
95-2575892 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualHeidi Tam
Street Address
4680 Wilshire Blvd., Sixth Floor
CityStateZip
Los AngelesCA90010
PhoneExtFaxE-Mail Address
(323) 930 - 7078  heidi.tam@farmersinsurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualNitinJParikh
Insurer TypeStreet Address of Practice
Licensed1061 Medical Center Drive, # 103
CityStateZip CodeCounty
Orange CityFL32763Volusia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
011808283-0000$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME60089Gastroenterology - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FVolusia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
FISH MEMORIAL100072
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
9/6/20017/2/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
A Gallbladder ultrasound revealed gallstones & an enlarged common bile duct.The insured performed an ERCP, a normal paceratogram was noted with no grooves seen.Co-defendant doctor concluded that the common bile duct was giving dilation appearance because of a cystic duct was wrapping around it, but no stones were seen.Co-defendant doctor recommended a surgical consultation to address the patient?s gallbalder.Patient underwent exploratory laparotomy and cholecystectomy and hemorrhagic panceratitis was found.Patient expired as a result of exacerbated pancreatitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Endoscopic retrograde cholangiopancreatography (ERCP_ patient developed severe hemorrhagic pancreatitis resulting in her demise.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Plaintiff alleges that the patient?s pancreatitis was exacerbated by an unnecessary ERCP performed by the insured. As a result the patient?s condition deteriorated and she subsequently died 1-1/2 weeks later.
Principal Injury Giving Rise To The Claim
Wrongful Death.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/18/20022002 11766 cidl
County Suit Filed inDate of Final Disposition
Volusia10/6/2004
Other Defendants Involved in this Claim
Capulung, Rene
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
10/8/2004
 
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$33,690
All Other Loss Adjustment Expense Paid$28,436
Injured Person's Total Non-Economic Loss$750,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
None.The insured had no liability in this matter.It was the surigical procedure that caused a worsening of the pancreatitis which caused or contributed patient's death.
 
Updates
 
No updates found.

 

 

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Dr. Wing Yi Liu Medical Malpractice Lawsuits - Court Case # 2015 30491 CICI

Indemnity Paid: $750,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201782718
Claim Number : 323714
Date Submitted : 8/3/2017
 
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 Wing Yi   Liu
Insurer Type Street Address of Practice
Licensed 161 North Causeway, Suite C
City State Zip Code County
New Smyrna Beach FL 32169 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0915338 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME97585 Surgery - Cardiac  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution Florida Hospital Ormond Beach
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Special Procedure Room  
Date of Occurrence Date Reported to Insurer
9/22/2012 10/22/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the ED with onsets of acute chest pain. Patient had pericardial tamponade.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in performing a pericardiocentesis.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Hypoxic brain injury.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
5/27/2015 2015 30491 CICI
County Suit Filed in Date of Final Disposition
Volusia 7/10/2017
Other Defendants Involved in this Claim
Hewes, Robert
Hatton, Nicholas
Florida Hospital Healthcare Partners Inc
Memorial Health Systems Inc. D/B/A Florida Hospital Memorial
Fornace, Donald
Patel, Kiran
Donaldson, Charles
Volusia Hospitalists
Panja, Jawed
Lightburn, Winston
Gable, Michael
Smith, Scott W
Marcum, James P
Mun Chih Lai, Angel
JH Gatewood Emergency Services
Florida Health Care Plan, Inc.
Complete Cardiology Care, PA
Medina, Roberto
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
7/10/2017
 
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 $71,165
All Other Loss Adjustment Expense Paid $25,228
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. Harry Black Medical Malpractice Lawsuits - Court Case # 2012-33280 CICI

Indemnity Paid: $725,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201472508
Claim Number : FP4266201
Date Submitted : 12/10/2014
 
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 Harry   Black
Insurer Type Street Address of Practice
Licensed 1340 Ridgewood Avenue
City State Zip Code County
Holly Hill FL 32117 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
FP-CL098490 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME48766 Surgery - General  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
HALIFAX MEDICAL CENTER 100017
Location of Institutional Injury Other Location of Institutional Injury
Operating Suite  
Date of Occurrence Date Reported to Insurer
6/23/2010 1/26/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Thyroid cancer papillary carcinoma.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Total thyroidectomy.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Bilateral lacerations of patients vocal cords.
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
1/7/2013 2012-33280 CICI
County Suit Filed in Date of Final Disposition
Volusia 10/24/2014
Other Defendants Involved in this Claim
Florida Healthcare Plans, Inc.
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court 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 $725,000
Loss Adjust Expense Paid to Defense Counsel $65,297
All Other Loss Adjustment Expense Paid $35,204
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate
 
Updates
 
 
Date of Change: 12/10/2014 10:38:26 AM
Reason for Change: Correction to injury location.
 
Field Changed Former Value New Value
Name of Institution HALIFAX MEDICAL CENTER
Other Location Where Injured Florida Health Care Plan
Location Where Injured Other Outpatient Facility Hospital Inpatient Facility

 

 

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

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Dr. Janak H Bhavsar Medical Malpractice Lawsuits - Court Case # 2016 11092 CIDL

Indemnity Paid: $700,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201782779
Claim Number : 338846
Date Submitted : 8/10/2017
 
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 Janak H Bhavsar
Insurer Type Street Address of Practice
Licensed 630 West Plymouth Avenue
City State Zip Code County
Deland FL 32720 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
072496 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME110155 Surgery - Cardiac  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution Florida Hospital Deland
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
3/23/2014 2/4/2016
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
The patient presented to the ER with unstable angina.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The insured cardiologist evaluated the patient.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Death.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
7/19/2016 2016 11092 CIDL
County Suit Filed in Date of Final Disposition
Volusia 7/25/2017
Other Defendants Involved in this Claim
Emergency Medicine Professionals, PA
Lewis & Klancke Cardiology, PA d/b/a Daytona Heart Group
Memorial Hospital West Volusia, Inc.
Haws, Kirby
Offiong, Dominic
Eastside Hospitalists, Inc.
Bhavsar, Janak
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
Other Dismissed
Arbitration
Claim not subject to Arbitration.
Date of Payment
7/25/2017
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $700,000
Loss Adjust Expense Paid to Defense Counsel $27,563
All Other Loss Adjustment Expense Paid $15,622
Injured Person's Total Non-Economic Loss $700,000
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. Yong-Hsiung Tsai Medical Malpractice Lawsuits - Court Case # 205 30965 CICI

Indemnity Paid: $595,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201886572
Claim Number : 326244
Date Submitted : 9/27/2018
 
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 Yong-Hsiung   Tsai
Insurer Type Street Address of Practice
Licensed 1893 North Clyde Morris Blvd. Suite 110
City State Zip Code County
Daytona Beach FL 32117 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0954146 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME64530 Rheumatology - 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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
HALIFAX MEDICAL CENTER 100017
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
7/29/2013 1/16/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented with dehydration, hypokalemia, abdominal pain and intractable vomiting. She was later diagnosed with Takayasu's arteritis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Rheumatology consultation and steroid treatment/management.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Disputed allegations of failing to adequately and timely treat Takayasu's.
Principal Injury Giving Rise To The Claim
Mesenteric ischemia and 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
7/1/2015 205 30965 CICI
County Suit Filed in Date of Final Disposition
Volusia 9/5/2018
Other Defendants Involved in this Claim
Nasr, MD, Issam
Hemaidan, MD, Ammar
Halifax Medical Center
Bratu, MD, Beatrice
Zulfiqar, MD, Hassan
Suleiman, MD, Saud
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
9/6/2018
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $595,000
Loss Adjust Expense Paid to Defense Counsel $78,194
All Other Loss Adjustment Expense Paid $45,496
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. Joan W Iacobelli Medical Malpractice Lawsuits - Court Case # 2014-11919 CIDL

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885670
Claim Number : 70351-B
Date Submitted : 6/20/2018
 
Insurer Information
 
Insurer Name Coverage Type
MEDMAL DIRECT INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
27-2813188  
Insurer Contact Information
Type First Name MI Last Name
Individual James P Lacey
Street Address
76 South Laura Street, Suite 900
City State Zip
Jacksonville FL 32202
Phone Ext Fax E-Mail Address
(904) 482 - 4068   (888) 974 - 6458 claims@medmaldirect.com
 
Insured Information
 
Type First Name MI Last Name
Individual Joan W Iacobelli
Insurer Type Street Address of Practice
Licensed 2864 Wellness Avenue, Suite 200
City State Zip Code County
Orange City FL 32763 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
FL707472 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME108529 Surgery - General  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Hospital Inpatient Facility  
Name of Institution Code
FISH MEMORIAL 100072
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
9/3/2013 6/18/2014
 
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
Medical management.
Diagnostic Code : 09
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
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
10/2/2014 2014-11919 CIDL
County Suit Filed in Date of Final Disposition
Volusia 5/28/2018
Other Defendants Involved in this Claim
Steinbaum, Jeremy
North Orlando Surgical Group
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
6/6/2018
 
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 $106,819
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.
 
Updates
 
No updates found.

 

 

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Dr. Ammar Hemaidan Medical Malpractice Lawsuits - Court Case # 2015 3096 CICI

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885688
Claim Number : 326237
Date Submitted : 6/20/2018
 
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 Ammar   Hemaidan
Insurer Type Street Address of Practice
Licensed 1690 Dunlawton Avenue
City State Zip Code County
Port Orange FL 32127 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0915338 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME78370 Surgery - Gastroenterology  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution Halifax Medical Center
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
7/29/2013 1/16/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the ED with intractable nausea/vomiting and a recent 40lb weight loss. The patient suffered from Takayasu Areitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in diagnosis of mesenteric ischemia.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Death.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
7/10/2015 2015 3096 CICI
County Suit Filed in Date of Final Disposition
Volusia 6/4/2018
Other Defendants Involved in this Claim
Halifax Hospital
Tsai, MD, Yong-Hsiung
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
6/4/2018
 
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 $20,600
All Other Loss Adjustment Expense Paid $5,227
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. SAUD E EL-SAYED SULEIMAN Medical Malpractice Lawsuits - Court Case # 2015 30965 CICI

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885689
Claim Number : 326238
Date Submitted : 6/20/2018
 
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 SAUD E EL-SAYED SULEIMAN
Insurer Type Street Address of Practice
Licensed 1690 Dunlawton Avenue
City State Zip Code County
Port Orange FL 32127 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0915338 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME83037 Surgery - Gastroenterology  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution HALIFAX MEDICAL CENTER
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
7/29/2013 1/16/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the ED with intractable nausea/vomiting and a recent 40lb weight loss. The patient suffered from Takayasu Areitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in diagnosis of mesenteric ischemia.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Death.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
7/10/2015 2015 30965 CICI
County Suit Filed in Date of Final Disposition
Volusia 6/4/2018
Other Defendants Involved in this Claim
Halifax Hospital
Tsai, MD, Yong-Hsiung
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
6/4/2018
 
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 $20,600
All Other Loss Adjustment Expense Paid $5,227
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. Hassan Zulfiqar Medical Malpractice Lawsuits - Court Case # 2015 3096 CICI

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885691
Claim Number : 326242
Date Submitted : 6/20/2018
 
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 Hassan   Zulfiqar
Insurer Type Street Address of Practice
Licensed 1690 Dunlawton Avenue
City State Zip Code County
Port Orange FL 32127 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0915338 $1,000,000 $3,000,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME78417 Surgery - Gastroenterology  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution HALIFAX MEDICAL CENTER
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
7/29/2013 1/16/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the ED with intractable nausea/vomiting and a recent 40lb weight loss. The patient suffered from Takayasu Areitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in diagnosis of mesenteric ischemia.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was none.
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
7/10/2015 2015 3096 CICI
County Suit Filed in Date of Final Disposition
Volusia 6/4/2018
Other Defendants Involved in this Claim
Halifax Hospital
Tsai, MD, Yon-Hsiung
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
6/4/2018
 
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 $21,514
All Other Loss Adjustment Expense Paid $4,523
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. Hendrik Dinkla Medical Malpractice Lawsuits - Court Case # 2013-12384-CIDL

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201575199
Claim Number : FP4395201
Date Submitted : 7/15/2015
 
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 Hendrik   Dinkla
Insurer Type Street Address of Practice
Licensed 742 West Plymouth Avenue
City State Zip Code County
Deland FL 32720 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
FP-IN008528 $500,000 $1,500,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME53372 Surgery - Neurology - Including Child  

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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Hospital/Institution Florida Hospital Deland #100045
Name of Institution Code
   
Location of Institutional Injury Other Location of Institutional Injury
Patients' Room  
Date of Occurrence Date Reported to Insurer
9/20/2010 1/10/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the emergency department with complaints of lower extremity weakness. He was ultimately diagnosed with Guillain-Barre Syndrome and transverse myelitis.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Alleged delay in diagnosis resulting in paresthesia.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Paresthesia.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
9/18/2013 2013-12384-CIDL
County Suit Filed in Date of Final Disposition
Volusia 6/22/2015
Other Defendants Involved in this Claim
Florida Hopsital Deland
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 $81,048
All Other Loss Adjustment Expense Paid $18,774
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $0 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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

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Dr. Jawed A Panja Medical Malpractice Lawsuits - Court Case # 2015-30491-CIDI

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201780848
Claim Number : 51217
Date Submitted : 4/11/2017
 
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 Jawed A Panja
Insurer Type Street Address of Practice
Licensed PO Box 730426
City State Zip Code County
Ormond Beach FL 32173 Volusia
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PSL 1602821 03 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME72018 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 Volusia
City State Zip Code
     
Location where injury occured Other location where injury occured
Emergency Room  
Name of Institution Code
MEMORIAL HOSPITAL-WEST VOLUSIA 100045
Location of Institutional Injury Other Location of Institutional Injury
Radiology, Emergency Room  
Date of Occurrence Date Reported to Insurer
9/22/2012 10/20/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Cardiac tamponade
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 diagnose cardiac tamponade
Principal Injury Giving Rise To The Claim
Hypoxic brain injury
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of Suit Circuit Court Case Number
3/25/2015 2015-30491-CIDI
County Suit Filed in Date of Final Disposition
Volusia 3/24/2017
Other Defendants Involved in this Claim
Marcum, PA-C, James
Medina, MD, Roberto
Patel, MD, Kiran N
Smith, DO, Scott
Hewes, MD, Robert
Hatton, MD, Nicholas
FHMMC
Fornace, DO, Donald
Volusia Hospitalists
Donaldson, MD, Charles
Lightburn, MD, Winston
Gable, MD, Michael
Chih Lai, PA-C, Angel M
Gatewood Emergency Service
Yi Liu, MD, Wing
Wang, MD, Huijian
Complete Cardiology Care
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
Settled by parties
Court Decision Other
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/12/2016
 
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 $24,255
All Other Loss Adjustment Expense Paid $10,543
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $1,000,000 $10,000,000
Wage Loss $0 $500,000
Other Expenses $0 $250,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change: 2/10/2017 11:43:26 AM
Reason for Change: Report updated to reflect Court Document final disposition date of 02/01/17
 
Field Changed Former Value New Value
Date of Final Disposition 12-DEC-16 01-FEB-17
 
Date of Change: 4/11/2017 10:26:30 AM
Reason for Change: Report updated to reflect Court Document final disposition date of 03/24/17
 
Field Changed Former Value New Value
Date of Final Disposition 01-FEB-17 24-MAR-17

 

 

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