Dr. DAVID H JABLONSKI, MD Medical Malpractice Cases, Lawsuits, and Complaints

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Phycicians Practice Address

Dr. DAVID H JABLONSKI, MD

1812 N Mills Ave

Orlando, FL

32803

Orange

Court Case # 2012-CA-014307-0

Indemnity Paid: $140,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Department File Number :	M201576378
Claim Number :	40287
Date Submitted :	2/4/2016

Insurer Information

Insurer Name				Coverage Type
MAG MUTUAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
58-1449198
Insurer Contact Information
Type		Entity Name
Entity		MAG MUTUAL INSURANCE COMPANY
Street Address
8427 South Park Circle Suite 130
City				State	Zip
Orlando				FL	32819
Phone	Ext	Fax	E-Mail Address
(407) 370 - 3813		(407) 370 - 2247	ctschanz@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	David		H	Jablonski
Insurer Type		Street Address of Practice
Licensed		1812 N Mills Ave
City		State	Zip Code	County
Orlando		FL	32803	Orange
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1602699 01		$500,000		$1,500,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME65714		Surgery - Urological

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

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

Location where injury occured		Other location where injury occured
Other Outpatient Facility		Urological Ambulatory Surgery Center
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
6/24/2010		2/17/2012

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Varicocele
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Ligation surgery
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure and diagnose and treat impaired blood flow
Principal Injury Giving Rise To The Claim
Atrophy of testicle
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
9/10/2012			2012-CA-014307-0
County Suit Filed in			Date of Final Disposition
Orange			1/19/2016
Other Defendants Involved in this Claim
Winter Park Urology Assoc.
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
11/5/2015

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$140,000

Loss Adjust Expense Paid to Defense Counsel

$95,300

All Other Loss Adjustment Expense Paid

$35,955

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$25,000	$200,000
Wage Loss	$0	$0
Other Expenses	$0	$0

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

Risk management has counseled insured

Updates

Date of Change:

2/4/2016 1:07:05 PM

Reason for Change:

Report updated to reflect Court Document final disposition date of 01/19/16

Field Changed	Former Value	New Value
Date of Final Disposition	05-NOV-15	19-JAN-16

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Court Case # 2015-CA-7071-O

Indemnity Paid: $0.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Department File Number :	M201679111
Claim Number :	47149
Date Submitted :	7/18/2016

Insurer Information

Insurer Name				Coverage Type
MAG MUTUAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
58-1449198
Insurer Contact Information
Type		Entity Name
Entity		MAG MUTUAL INSURANCE COMPANY
Street Address
8427 South Park Circle Suite 130
City				State	Zip
Orlando				FL	32819
Phone	Ext	Fax	E-Mail Address
(407) 370 - 3813		(407) 370 - 2247	ctschanz@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	David		H	Jablonski
Insurer Type		Street Address of Practice
Licensed		1812 N. Mills Ave.
City		State	Zip Code	County
Orlando		FL	32803	Orange
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PRF 1410754 00		$500,000		$1,500,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME65714		Surgery - Urological

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	Orange
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
Patients' Room
Date of Occurrence		Date Reported to Insurer
11/1/2010		12/30/2013

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Bladder cancer
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Administration of BCG
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged improper administration of incorrect medication
Principal Injury Giving Rise To The Claim
Tuberculosis of the spinal cord
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
7/31/2015			2015-CA-7071-O
County Suit Filed in			Date of Final Disposition
Orange			6/16/2016
Other Defendants Involved in this Claim
Winter Park Urology Assoc.
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?

Indemnity Paid by Insurer on behalf of Insured

Loss Adjust Expense Paid to Defense Counsel

$21,990

All Other Loss Adjustment Expense Paid

$3,380

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$133,000	$0
Wage Loss	$0	$0
Other Expenses	$0	$0

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

Risk management has counseled insured

Updates

No updates found.

This page is not displaying certain sensitive information.

Frequently Asked Questions

Does Dr. DAVID H JABLONSKI, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. DAVID H JABLONSKI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).

Medical Malpractice Cases