Department File Number : | M201782485 |
Claim Number : | 1 |
Date Submitted : | 7/3/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Theodotou, Basil | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-348700 | ME46303 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Basil | Theodotou | |||
Street Address | |||||
32 Suntree Place | |||||
City | State | Zip | |||
Melbourne | FL | 32940 | |||
Phone | Ext | Fax | E-Mail Address | ||
(321) 752 - 7001 | 5 | (321) 254 - 1776 | theodotou@cfl.rr.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Basil | Theodotou | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 32 Suntree Place | ||||
City | State | Zip Code | County | ||
Melbourne | FL | 32940 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
Escrow account 205-1035 | $250,000 | $250,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME46303 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HOLMES REGIONAL MEDICAL CENTER | 100019 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Patient room/ICU | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/11/2009 | 8/19/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Raised intracranial pressure from epidural blood, cerebral contusion, subarachnoid hemorrhage and skull fracture | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Delay | |||||
Diagnostic Code : | 852.41 | ||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Delay in treatment for increased intracranial pressure. | |||||
Principal Injury Giving Rise To The Claim | |||||
Car vs scooter head injury without helmet use. | |||||
Severity Of Injury | |||||
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/18/2012 | 052012CA020556XXXXXX | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 6/20/2017 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
6/2/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Hire attorney |
Updates | |
No updates found. |
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Department File Number : | M201783384 |
Claim Number : | 201220556 |
Date Submitted : | 10/17/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Theodotou, Basil | Primary | ||||
Insurer FEIN | Professional License Number | ||||
999999 | ME46303 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Stephen | Sambol | |||
Street Address | |||||
225 E. Robinson Street #600 | |||||
City | State | Zip | |||
Orlando | FL | 32801 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 425 - 9044 | 171 | (407) 423 - 2016 | dmalinowski@mateerharbert.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Basil | Theodotou | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 32 Suntree Place | ||||
City | State | Zip Code | County | ||
Melbourne | FL | 32940 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
111111 | $250,000 | $250,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME46303 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HOLMES REGIONAL MEDICAL CENTER | 100019 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/3/2009 | 8/25/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Increasing inter cranial pressure requiring a craniotomy. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged failure to diagnose impending herniation that required a decompressive craniotomy. | |||||
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: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/21/2012 | 05-2012-CA020556 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 6/9/2017 | ||||
Other Defendants Involved in this Claim | |||||
Holmes Regional Medical Center Packey, David J | |||||
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 | |||||
6/5/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $300,754 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $16,561 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Better documentation of interaction with patient and communications. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. One or more fields in this claim have failed internal data validation testing. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. |
Department File Number : | M201988550 |
Claim Number : | 01 |
Date Submitted : | 4/21/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE SPECIALTY INSURANCE COMPANY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-3990058 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Imraan | Ansaarie | |||
Street Address | |||||
209 Pinehurst Pointe Drive | |||||
City | State | Zip | |||
Saint Augustine | FL | 32092 | |||
Phone | Ext | Fax | E-Mail Address | ||
(386) 983 - 6838 | (386) 222 - 3064 | iansaarie@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Imraan | Ansaarie | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 211 North Eddy Street | ||||
City | State | Zip Code | County | ||
South Bend | IN | 48278 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP44397 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME121178 | Cardiovascular Disease - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Out of state | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/12/2011 | 3/12/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Abdominal Aortic Aneurysm of > 5.5 cm | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Endovascular device was placed by the primary physician. I was the proctoring physician. The primary MD placed the EVAR device at the level of the renal arteries. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient went into acute renal failure in another hospital. The EVAR procedure was deemed responsible for the patients condition. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/1/2014 | 71D06-1611-CT-508 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Out of state | 9/29/2017 | ||||
Other Defendants Involved in this Claim | |||||
Aslam, Shakil | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $67,001 | ||||||||||||||||||||
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 | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Better planning and improved patient follow up |
Updates | |
No updates found. |
Does Dr. BASIL THEODOTOU, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BASIL THEODOTOU, MD has at least 5 medical malpractice case(s), lawsuit(s), or complaint(s).