| Department File Number : | M201575646 |
| Claim Number : | 107-008259 |
| Date Submitted : | 8/26/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| LEXINGTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-1149494 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kayla | Roberson | |||
| Street Address | |||||
| 17200 W 119th St | |||||
| City | State | Zip | |||
| Olathe | KS | 66061 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (913) 495 - 6578 | Kayla.Roberson@aig.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Bret | J | Neiderman | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 119 Oakfield Dr | ||||
| City | State | Zip Code | County | ||
| Brandon | FL | 33511 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 6796927 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME101253 | Radiology - Diagnostic - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| BRANDON REGIONAL HOSPITAL | 100243 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/21/2009 | 12/29/2011 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Defendant failed to adequately communicate the CT findings consistent with severe left-sided sinusitis causing the left ethmoid air cells to expand, complete opacification of the left maxillary, left sphenoid, and left frontal sinuses. Failure to communicate the CT findings consistent with left periorbital cellulitis in a patient with severe left-sided pansinusitis. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| A CT Scan of patient's face without contrast was performed on July 21 2009. She was diagnosed a single contusion with soft tissue hematoma to the face, blepharitis, left eye and acute sinusitis, then discharged home. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| As a direct and proximate result of the negligence of defendant, the patient suffered two brain abscesses, bilateral no light perception blindness, left hemiparesis, and other permanent and severe neurologic injuries. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient arrived at the Emergency Department at Brandon Regional Hospital with complaint of a swollen left eye. | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/28/2012 | 12 004960 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 8/18/2015 | ||||
| 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 | |||||
| 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 | $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 | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201472681 |
| Claim Number : | 107-015691 |
| Date Submitted : | 11/17/2014 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| LEXINGTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-1149494 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | LORRAINE | S | PRENDERGAST | ||
| Street Address | |||||
| 3650 BROOKSIDE PARKWAY | |||||
| City | State | Zip | |||
| ALPHARETTA | GA | 30022 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (678) 240 - 1238 | (855) 674 - 8541 | lorraine.prendergast@aig.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | BRET | NEIDERMAN | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 100 S ASHLEY DR | ||||
| City | State | Zip Code | County | ||
| TAMPA | FL | 33602 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 6796927 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME101253 | Radiology - Diagnostic - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | FLORIDA IMAGING ASSOCIATES | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/11/2010 | 2/19/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| FAILED TO PROPERLY INTERPRET PLT'S CT SCAN OF THE ABODOMEN AND PELVIS AND DOCUMENT THE PRESENCE OF AIR IN THE UTERINE WALL AND FAILED TO TREAT ACCORDINGLY. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| FAILED TO PROPERLY INTERPRET PLT'S CT SCAN OF THE ABODOMEN AND PELVIS AND DOCUMENT THE PRESENCE OF AIR IN THE UTERINE WALL AND FAILED TO TREAT ACCORDINGLY. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| FAILED TO PROPERLY INTERPRET PLT'S CT SCAN OF THE ABODOMEN AND PELVIS AND DOCUMENT THE PRESENCE OF AIR IN THE UTERINE WALL AND FAILED TO TREAT ACCORDINGLY. | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 6/20/2014 | ||||
| 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 | ||||
| Other | SETTLED DURING DISCOVERY | ||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 6/20/2014 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $300,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $27,582 | ||||||||||||||||||||
| 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 ASSESS PEATIENTS | |||||||||||||||||||||
| Updates | |
| No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
| Department File Number : | M201886451 |
| Claim Number : | 107-015691 |
| Date Submitted : | 9/17/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| LEXINGTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-1149494 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | carolyn | r | ewell | ||
| Street Address | |||||
| 17200 W 119th St | |||||
| City | State | Zip | |||
| Olathe | KS | 66061 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (913) 495 - 4217 | carolynranee.ewell@aig.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Bret | Neiderman | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 100 S Ashley Dr | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33602 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 6796927 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME101253 | Physicians or Surgeons | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Florida Imaging Associates | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/11/2010 | 2/19/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| FAILED TO PROPERLY INTERPRET PLT'S CT SCAN OF THE ABODOMEN AND PELVIS AND DOCUMENT THEPRESENCE OF AIR IN THE UTERINE WALL AND FAILED TO TREAT ACCORDINGLY | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| FAILED TO PROPERLY INTERPRET PLT'S CT SCAN OF THE ABODOMEN AND PELVIS AND DOCUMENT THEPRESENCE OF AIR IN THE UTERINE WALL AND FAILED TO TREAT ACCORDINGLY. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| FAILED TO PROPERLY INTERPRET PLT'S CT SCAN OF THE ABODOMEN AND PELVIS AND DOCUMENT THEPRESENCE OF AIR IN THE UTERINE WALL AND FAILED TO TREAT ACCORDINGLY. | |||||
| 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 | ||||
| 9/30/2011 | 11 12424 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 6/20/2014 | ||||
| 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 | ||||
| Other | Settled During Discovery | ||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 6/20/2014 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $27,582 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201782248 |
| Claim Number : | 1037170-02 |
| Date Submitted : | 9/13/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 47-6021331 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Myra | Lassen | |||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Ft Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (800) 463 - 3776 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Bret | Neiderman | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 100 S Ashley, Suite 1500 | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33602 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HN006099 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME101253 | Radiology - Diagnostic - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BRANDON REGIONAL HOSPITAL | 100243 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/11/2015 | 9/7/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Crush injury to hand | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Read of imaging studies | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Failure to diagnose dislocation of the distal radial ulnar injury | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Pain & suffering, delay in treatment | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 5/12/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Nichols, MD, Eddie Brandon Regional Hospital Florida Orthopaedic Institute Stone, MD, Terrance PAL, AMIT | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Settlement Reached Prior to Pre-Suit Period | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 5/12/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $15,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $12,769 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $9,705 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |||||||
| Date of Change: | 9/13/2017 1:21:56 PM | ||||||
| Reason for Change: | ALE Update | ||||||
| |||||||
*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 : | M201987755 |
| Claim Number : | 1036731-02 |
| Date Submitted : | 1/30/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 47-6021331 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Michelle | Pierron | |||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Ft Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (800) 463 - 3776 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Bret | J | Neiderman | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2102 Trinity Oaks Blvd | ||||
| City | State | Zip Code | County | ||
| New Port Richey | FL | 34655 | Pasco | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HN006099 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME101253 | Radiology - Diagnostic - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BAYFRONT MEDICAL CENTER | 100032 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 9/5/2014 | 9/8/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Severe headache, nausea, vomiting | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Read of a CTA of the head and a CT of the brain | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to diagnose aneurysm and place aneurysm on the differential diagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death from brain bleed | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 1/16/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Bayfront Health Brooksville | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| After arbitration is initiated or prior to suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Dropped before Action Filed | |||||
| 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? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $22,728 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| NA | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. BRET J NEIDERMAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BRET J NEIDERMAN, MD has at least 5 medical malpractice case(s), lawsuit(s), or complaint(s).