Department File Number : | M201679559 |
Claim Number : | 333269 |
Date Submitted : | 8/29/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Brian | M | Jurbala | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 416 Morningside Drive | ||||
City | State | Zip Code | County | ||
Lakeland | FL | 33803 | Polk | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0955242 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME70116 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Polk | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Physicians Office | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physicians Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/22/2013 | 8/20/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient suffered a twisting injury to his left leg while playing football on the beach. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient presented 5 days after his injury with complaint of knee pain. He was seen and treated conservatively including physical therapy. He was discharged 2 months later. He reported being 100% better with no complaint of pain. Hip exams were normal with no symptoms of SCFE. Knee pain completely resolved. Clinical and radiologic exam were not indicative of SCFE. Patient had sudden onset of hip pain 7 months after discharge after playing sports and found to have SCFE fracture. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged patient was suffering a SCFE when seen post-injury and that it was missed. | |||||
Principal Injury Giving Rise To The Claim | |||||
SCFE fracture. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/5/2016 | 2015CA4117 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Polk | 8/1/2016 | ||||
Other Defendants Involved in this Claim | |||||
Highland Center for Orthopaedics & Upper Extremity Surgery, | |||||
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 | |||||
8/1/2016 |
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 | $10,513 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $735 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
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Does Dr. BRIAN M JURBALA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BRIAN M JURBALA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).