Department File Number : | M201678750 |
Claim Number : | 0AB108589 |
Date Submitted : | 6/16/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HOMELAND INSURANCE COMPANY OF NEW YORK | Primary | ||||
Insurer FEIN | Professional License Number | ||||
52-1568827 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mike | Clark | |||
Street Address | |||||
199 Scott Swamp Road | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 321 - 2544 | (877) 256 - 5067 | mclark@onebeaconpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DMITRIY | G | CHATSKIY | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8971 Daniels Center Dr #307 | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33912 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PHY071714 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS9038 | Hospitalists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Hospital inpatient facility | ||||
Date of Occurrence | Date Reported to Insurer | ||||
10/19/2014 | 10/29/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Claimant presented to the ER on 7/23/12 for complaints of left foot pain. Notably, he had had an IV in that foot during a hospitalization of 7/18-7/20/12. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent debridement and partial amputation of his foot | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
IV placed in his right foot infiltrated resulting in compartment syndrome. | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged that during the hospitalization of 7/23/12, an IV placed in his right foot infiltrated resulting in compartment syndrome. This required debridement and later a partial foot amputation. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/16/2015 | 2015-CA-530 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 6/9/2016 | ||||
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 | |||||
6/7/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $32,097 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown at this time |
Updates | |
No updates found. |
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Does Dr. DMITRIY G CHATSKIY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DMITRIY G CHATSKIY, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).