Dr. ANNABELLE H CLEMENT, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. ANNABELLE H CLEMENT, MD

4308 Alton Rd, STE750

Indemnity Paid: $0.00

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	Myra		J	Lassen
Street Address
5814 Reed Road
City				State	Zip
Fort Wayne				IN	46835
Phone	Ext	Fax	E-Mail Address
(260) 486 - 0340			reportaclaim@medpro.com

Insured Information

Type	First Name		MI	Last Name
Individual	Annabelle		H	Clement
Insurer Type		Street Address of Practice
Licensed		4308 Alton Rd, STE750
City		State	Zip Code	County
Miami Beach		FL	33140	Dade
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
A12116		$500,000		$1,000,000
Profession or Business			Other Profession or Business
Other			Physician Assistant
License Number		Specialty Code & Classification		Certification Number
PA9103212

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Dade
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
7/7/2011		6/21/2012

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Tattoo underside of wrist
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Laser tattoo removal left wrist
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Improper tattoo remova causing 3rd degree burns
Principal Injury Giving Rise To The Claim
Debridement and hospital stay
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed.

Legal Information

Date of Suit			Circuit Court Case Number
2/14/2013			13-05679CA02
County Suit Filed in			Date of Final Disposition
Dade			12/3/2014
Other Defendants Involved in this Claim
Zaiac, MD, Martin Martin Zaiac MD PA
Stage of Legal System at which Settlement was Reached or Award Made
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference.
Final Method of Claim Disposition
No Payment Made
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?

Indemnity Paid by Insurer on behalf of Insured

Loss Adjust Expense Paid to Defense Counsel

$97,787

All Other Loss Adjustment Expense Paid

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

N/A

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Does Dr. ANNABELLE H CLEMENT, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. ANNABELLE H CLEMENT, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).

Medical Malpractice Cases