Department File Number : | M202091119 |
Claim Number : | CLA0479061 |
Date Submitted : | 1/16/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
94-2301054 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jacqueline | Lakins | |||
Street Address | |||||
PO Box 2080 | |||||
City | State | Zip | |||
Mechanicsburg | PA | 17055 | |||
Phone | Ext | Fax | E-Mail Address | ||
(717) 796 - 5421 | jlakins@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Douglas | Kuperman | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 10920 Technology Ter | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34211 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
721294N | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME43099 | Surgery - Gastroenterology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Sarasota | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SARASOTA MEMORIAL HOSPITAL | 100087 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/9/2018 | 12/20/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Recurrent acute pancreatitis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Upper Endoscopy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/9/2019 | 2019-CA-003945-NC | ||||
County Suit Filed in | Date of Final Disposition | ||||
Sarasota | 1/2/2020 | ||||
Other Defendants Involved in this Claim | |||||
Sweeney, Erica McKeon, Kendall Sarasota County Public Hospital District Sarasota Anesthesiologists PA Salinas, Rafael | |||||
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 | |||||
1/6/2020 |
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 | $18,500 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $316 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
None |
Updates | |
No updates found. |
Department File Number : | M202091333 |
Claim Number : | F15-0052-B-11 |
Date Submitted : | 2/4/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FD INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3704679 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Steven | R | Carey | ||
Street Address | |||||
4651 Salisbury Rd. Suite 410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 309 - 8127 | (904) 309 - 8127 | scarey@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Douglas | Kuperman | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 10920 Technology Terrace | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34211 | Sarasota | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MG001162 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME43099 | Gastroenterology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Sarasota | ||||
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 | ||||
6/1/2011 | 3/12/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to be evaluated for a liver mass. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Physician ordered an MRI of the liver, a CT scan, and ordered that a colonoscopy be completed within 6 months. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleging physician failed to order and perform proper diagnostic tests including an Alpha-Fetoprotein test and failed to diagnose liver cancer. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient expired. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/16/2015 | 2015CA004589AX | ||||
County Suit Filed in | Date of Final Disposition | ||||
Manatee | 1/6/2020 | ||||
Other Defendants Involved in this Claim | |||||
Montero, MD, Carlos Florida Digestive Health Specialists Arias, MD, Carlos Gastroenterology Associates of Manatee | |||||
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 | |||||
1/6/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $65,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $61,773 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Circumstances of the case have been discussed with the insured and Risk Management. |
Updates | |
No updates found. |
Does Dr. DOUGLAS KUPERMAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DOUGLAS KUPERMAN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).