Department File Number : | M201988714 |
Claim Number : | CLA0394798 |
Date Submitted : | 5/9/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
94-2301054 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Diane | M | McNab | ||
Street Address | |||||
16630 HAYNIE LANE | |||||
City | State | Zip | |||
Jupiter | FL | 33478 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 439 - 0580 | dmcnab@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Brian | K | Zebrowski | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 18944 North Dale Mabry Highway, Suite 102 | ||||
City | State | Zip Code | County | ||
Lutz | FL | 33548 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
724730N | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME97075 | Surgery - General |
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 | ||||
Florida Hospital Wesley Chapel | 23960099 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/31/2016 | 1/29/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the hospital with a hiatal hernia and gastric volvulus. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
This provider performed hiatal hernia repair with Nissen Fundoplication repair of the esophagus due to a leak and placement of gastrojejunal feeding tube. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient alleged improper performance of the hiatal hernia repair and Nissen Fundoplication of the esophagus resulting in complications and additional surgeries. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 4/19/2019 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
5/1/2019 |
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 | $35,446 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $35,446 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured conferenced with defense counsel and claims specialist |
Updates | |
No updates found. |
Does Dr. BRIAN K ZEBROWSKI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BRIAN K ZEBROWSKI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).