Department File Number : | M202092711 |
Claim Number : | PLFHMGO095705 |
Date Submitted : | 6/10/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Florida Physicians Medical Group | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-3214635 | 800014080 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Linda | Boelke | |||
Street Address | |||||
900 Hope Way | |||||
City | State | Zip | |||
Altamonte Springs | FL | 32714 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 357 - 1313 | linda.boelke@ahss.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dennis | Donahue | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 2600 Westhall Lane | ||||
City | State | Zip Code | County | ||
Maitland | FL | 32751 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
8258 - 2018 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME36999 | Surgery - Urological |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
FLORIDA HOSPITAL (ORLANDO) | 100007 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/5/2016 | 6/12/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Underwent an elective laser lithotripsy for hydronephrosis secondary to right ureteral stone. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged became septic post-procedure, developed septic shock. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Expired secondary to cardiac arrest from sepsis. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/7/2018 | 2018-CA-11809 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Orange | 5/22/2020 | ||||
Other Defendants Involved in this Claim | |||||
Florida Hospital Medical Group | |||||
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 | |||||
5/22/2020 |
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 | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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. |
Department File Number : | M201885282 |
Claim Number : | 51702 |
Date Submitted : | 5/10/2018 |
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 | Dennis | J | Donahue | ||
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 1603125 01 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME36999 | Surgery - Urological |
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 | ||||
5/20/2010 | 12/11/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Stage III adenocarcinoma of prostate | |||||
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 follow-up on elevated PSAs | |||||
Principal Injury Giving Rise To The Claim | |||||
Extensive surgery and increased risk of metastasis or recurrence | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/20/2015 | 15-CA-1688-O | ||||
County Suit Filed in | Date of Final Disposition | ||||
Orange | 3/29/2018 | ||||
Other Defendants Involved in this Claim | |||||
Mid-Florida Urological 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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $28,317 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,384 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |
No updates found. |
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Does Dr. DENNIS DONAHUE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DENNIS DONAHUE, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).