Dr. DAVID L SUSTARSIC, MD Medical Malpractice Cases, Lawsuits, and Complaints

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Phycicians Practice Address

Dr. DAVID L SUSTARSIC, MD

601 East Dixie Avenue, Ste 805

Leesburg, FL

34748

Lake

Court Case #

Indemnity Paid: $450,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Department File Number :	M201885040
Claim Number :	65346
Date Submitted :	4/13/2018

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		(404) 842 - 3319	ctschanz@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	David		L	Sustarsic
Insurer Type		Street Address of Practice
Licensed		511 Medical Plaza Dr., Ste. 101
City		State	Zip Code	County
Leesburg		FL	34748	Lake
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1602418 09		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME43704		Surgery - Vascular

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	Lafayette
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
VILLAGES REGIONAL HOSPITAL, THE		23960032
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
12/15/2015		12/28/2017

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Mesenteric ischemia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly evaluate and treat patient and diagnose mesenteric ischemia
Principal Injury Giving Rise To The Claim
Mesenteric ischemia
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
			*NR
County Suit Filed in			Date of Final Disposition
*NR			4/2/2018
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
4/2/2018

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$450,000

Loss Adjust Expense Paid to Defense Counsel

$5,338

All Other Loss Adjustment Expense Paid

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$348,192	$0
Wage Loss	$0	$0
Other Expenses	$1,954	$0

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

Risk management has counseled insured

Updates

No updates found.

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

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Court Case # 06CA887

Indemnity Paid: $25,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M200850676
Claim Number :	33715-01
Date Submitted :	8/29/2008

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	Odessa			Choice
Street Address
1000 Riverside Avenue, Suite 800
City				State	Zip
Jacksonville				FL	32204
Phone	Ext	Fax	E-Mail Address
(800) 741 - 3742	3045	(904) 358 - 6728	odessa.choice@fpic.com

Insured Information

Type	First Name		MI	Last Name
Individual	David			Sustarsic
Insurer Type		Street Address of Practice
Licensed		601 East Dixie Avenue, Ste 805
City		State	Zip Code	County
Leesburg		FL	34748	Lake
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
10344		$250,000		$750,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME43704		Surgery - General		80143

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	Marion
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
1/8/2005		2/9/2006

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Carotid Doppler Ultrasound demonstrated 60-70% right internal carotid stenosis and 50% left carotid stenosis, then a carotid angiogram noted 70-75% stenosis of the left carotid artery and 50% long tubular lesion of the right carotid artery.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Right carotid endarterectomy.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged treatment of right side stenosis prior to the left side.In any event, it was necessary to treat both sides due to extent of the disease.
Principal Injury Giving Rise To The Claim
Residual minor numbness on the right side of the neck and mild right side lip droop.
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
7/12/2006			06CA887
County Suit Filed in			Date of Final Disposition
Lake			8/13/2008
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 not subject to Arbitration.
Date of Payment
8/13/2008

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$25,000

Loss Adjust Expense Paid to Defense Counsel

$15,465

All Other Loss Adjustment Expense Paid

$11,472

Injured Person's Total Non-Economic Loss

$25,000

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$6,387	$0
Wage Loss	$0	$0
Other Expenses	$0	$0

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

Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.

Updates

No updates found.

This page is not displaying certain sensitive information.

Court Case #

Indemnity Paid: $0.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Department File Number :	M201676768
Claim Number :	46530
Date Submitted :	3/29/2016

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		L	Sustarsic
Insurer Type		Street Address of Practice
Licensed		511 Medical Plaza Dr. Ste. 101
City		State	Zip Code	County
Leesburg		FL	34748	Lake
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1602418 05		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME43704		Surgery - Vascular

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
			F	Lake
City			State	Zip Code

Location where injury occured		Other location where injury occured
Other Outpatient Facility		Florida Heart & Vascular Center
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Special Procedure Room
Date of Occurrence		Date Reported to Insurer
11/10/2011		10/30/2013

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Vascular insufficiency
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Pelvic aortography
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged performance of unnecessary procedure
Principal Injury Giving Rise To The Claim
Femoral puncture
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
			*NR
County Suit Filed in			Date of Final Disposition
*NR			2/10/2016
Other Defendants Involved in this Claim
Williams, MD, Patrick K The Villages Regional Hopsital
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
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

$56,173

All Other Loss Adjustment Expense Paid

$16,142

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$125,000	$0
Wage Loss	$0	$0
Other Expenses	$0	$100,000

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

Risk management has counseled insured

Updates

Date of Change:

3/29/2016 2:50:12 PM

Reason for Change:

Report updated to reflect Court Document final disposition date of 02/10/16

Field Changed	Former Value	New Value
Date of Final Disposition	15-DEC-15	10-FEB-16

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

This page is not displaying certain sensitive information.

Frequently Asked Questions

Does Dr. DAVID L SUSTARSIC, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. DAVID L SUSTARSIC, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).

Medical Malpractice Cases