| Department File Number : | M202092802 |
| Claim Number : | 1038385-01 |
| Date Submitted : | 6/23/2020 |
| 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 | Lynn | Louthan | |||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Ft Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0778 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Cesar | A | Euribe | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2300 S Pine Ave Ste C | ||||
| City | State | Zip Code | County | ||
| Ocala | FL | 34471 | Sumter | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 801542 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME45785 | Anesthesiology - Pain Management | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Sumter | ||||
| 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 | ||||
| 10/17/2016 | 11/10/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Severe neck and left upper extremity pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Cervical translaminar epidural steroid injection | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| improper performance of steroid injections | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Cardiopulmonary arrest and death | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/8/2018 | 2018-CA-000193 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Sumter | 6/9/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| Florida Pain & Rehabilitation Associates Inc dba Central Florida Pain Management | |||||
| 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 | |||||
| 6/8/2020 | |||||
| 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 | $17,287 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $8,659 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $125,000 | ||||||||||||||||||||
| 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. |
| Department File Number : | M201782625 |
| Claim Number : | FP4325702 |
| Date Submitted : | 7/20/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-6614702 | |||||
| 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 | Cesar | A | Euribe | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1503 Buenos Aires Blvd. Suite 150 | ||||
| City | State | Zip Code | County | ||
| Lady Lake | FL | 32159 | Lake | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FP39274 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME45785 | Anesthesiology - Pain Management | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Lake | ||||
| 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 | ||||
| Other | Physicians office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/6/2012 | 6/21/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Intractable lower back pain, left hip and radiating leg pain. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| LESI L3-L4. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Disputed allegations of failing to properly manage the patient's anti coagulation and obtain a formal cardiology consult before administering pain management injections. The patient suffered a fatal stroke. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/27/2015 | 2015CA000566 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Lake | 7/6/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Spencer, MD, Roger W | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| During trial, but before court verdict. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 7/6/2017 | |||||
| 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 | $148,243 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $43,499 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| 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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| Department File Number : | M201887242 |
| Claim Number : | 1042608-01 |
| Date Submitted : | 12/11/2018 |
| 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 | Lynn | Louthan | |||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Ft Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0778 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Cesar | A | Euribe | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1503 Buenos Aires Blvd Ste 150 | ||||
| City | State | Zip Code | County | ||
| Lady Lake | FL | 32159 | Sumter | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 801542 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME45785 | Family Physicians or General Practitioners - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Sumter | ||||
| 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 | ||||
| 2/19/2017 | 4/20/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| presented for routine IT pump refill | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| prescribed oral morphine 3x/day rather than refill pump & have complication while Dr off work | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| no know at this time | |||||
| Principal Injury Giving Rise To The Claim | |||||
| excruciating pain, withdrawals, needing sedation & intubation to secure airway | |||||
| 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 | ||||
| 2/16/2018 | 2018CA308 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Lake | 12/5/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Cesar Euribe MD PA Florida Pain And Rehabilitation | |||||
| 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? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $6,672 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,376 | ||||||||||||||||||||
| 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. |
Does Dr. CESAR A EURIBE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CESAR A EURIBE, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).