Dr. DAN G JACOBSON, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. DAN G JACOBSON, MD

432 Southeast Osceola Street

Indemnity Paid: $99,999.00

Insurer Information

Insurer Name				Coverage Type
Jacobson, Dan G				Primary
Insurer FEIN		Professional License Number
3		ME36695
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Michelle			Brown
Street Address
100 Brookwood Place
City				State	Zip
Birmingham				AL	35209
Phone	Ext	Fax	E-Mail Address
(205) 802 - 4754			mibrown@proassurance.com

Insured Information

Type	First Name		MI	Last Name
Individual	Dan		G	Jacobson
Insurer Type		Street Address of Practice
Self-Insurer		432 Southeast Osceola Street
City		State	Zip Code	County
Stuart		FL	34994	Martin
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
MP35648		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME36695		Gastroenterology - Minor Surgery

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	Martin
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Outpatient Facility
Name of Institution		Code
MARTIN MEMORIAL MEDICAL CENTER		100044
Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
10/30/2009		8/3/2010

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Colostomy and Hartmann's pouch
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Inadequate preparation for a colonscopy
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Failed to terminate a colonoscopy when it was noted there was inadequate preparation, resulting in a colostomy and Hartmann's pouch
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Legal Information

Date of Suit			Circuit Court Case Number
11/12/2010			10-2708CA
County Suit Filed in			Date of Final Disposition
Martin			11/1/2012
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 subject to arbitration, but settlement reached in lieu of award.
Date of Payment
11/6/2012

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$99,999

Loss Adjust Expense Paid to Defense Counsel

$32,030

All Other Loss Adjustment Expense Paid

$27,140

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Insured has discussed with insurance company and defense counsel.

Updates

Date of Change:

7/2/2014 12:27:35 PM

Reason for Change:

updated financials

Field Changed	Former Value	New Value
All Other Loss Adjustment Expense Paid	26294	27140

*NR:Prior to 04/28/1999 this field was not required in submitted claims.

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Does Dr. DAN G JACOBSON, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. DAN G JACOBSON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).