Department File Number : | M202092619 |
Claim Number : | 70757 |
Date Submitted : | 6/1/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Markavia | Martin | |||
Street Address | |||||
3535 Piedmont Rd NE | |||||
City | State | Zip | |||
Atlanta | GA | 30305 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 842 - 5600 | mmartin@magmutal.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Allan | Klaiman | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 668 N Orlando Ave Suite 105 | ||||
City | State | Zip Code | County | ||
Maitland | FL | 32751 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1603366 02 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME49054 | Surgery - Urological |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/19/2018 | 10/18/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Bladder cancer | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
radical cytoprostatectomy and right distal ureterectomy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to recognize a complication of treatment | |||||
Principal Injury Giving Rise To The Claim | |||||
Allegedly patient underwent radical cytoprostatectomy and right distal ureterectomy for bladder cancer resulting in patient aspirating and choking to death post-op. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/13/2019 | 2019-CA-000517-09M-W | ||||
County Suit Filed in | Date of Final Disposition | ||||
Seminole | 5/6/2020 | ||||
Other Defendants Involved in this Claim | |||||
Singh, Priamvada Buddendorff, Christopher Brown, James Birrey, Arvin Watts, Christine Klaiman Urology Central Florida Hospitalist Partners Adventist Health Syetm/ Sunbelt, Inc Florida Hospital Healthcare System | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
4/23/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $25,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $50,476 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $18,306 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk Management has counseled insured |
Updates | |
No updates found. |
Department File Number : | M202092792 |
Claim Number : | 70757 |
Date Submitted : | 6/22/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Markavia | Martin | |||
Street Address | |||||
3535 Piedmont Rd Building 14 Suite 1000 | |||||
City | State | Zip | |||
Atlanta | GA | 30305 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 842 - 5600 | mmartin@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ALLAN | KLAIMAN | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6680N Orlando Ave Ste 105 | ||||
City | State | Zip Code | County | ||
Maitland | FL | 32751 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1603366 02 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME49054 | Surgery - Urological |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/19/2016 | 10/18/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Bladder cancer | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
radical cytoprostatectomy and right ureterectomy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
failure to recognize a complication | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient underwent radical cytoprostatectomy and right distal ureterectomy for advanced bladder cancer. Patient was found unresponsive on post op day 4, suspected he aspirated, by nursing staff. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/13/2019 | 2019-CA-000517-09M-W | ||||
County Suit Filed in | Date of Final Disposition | ||||
Seminole | 5/6/2020 | ||||
Other Defendants Involved in this Claim | |||||
Buddendorff, Christopher Brown , James Birrey , Arvin Watts , Christine Klaiman urology Central FLorida Hospitalists Partners Adventist Health System Singh, Priamvada FLorida Hosital Healthcare System | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
4/23/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $25,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $56,668 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $18,306 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk Management has counseled insured |
Updates | |
No updates found. |
Does Dr. ALLAN KLAIMAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ALLAN KLAIMAN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).