| Department File Number : | M201576389 |
| Claim Number : | 29864 |
| Date Submitted : | 11/23/2015 |
| 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 | Fiordaliza | Toribio | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 6301 Memorial Hwy. Ste. 104 | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33615 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1602493 00 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME88065 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| TAMPA GENERAL HOSPITAL | 100128 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/26/2006 | 3/6/2009 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Right axillary vein thrombosis | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Prescribed Lovenox | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to properly manage anticoagulant therapy | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Acute retroperitoneal hemorrhage | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/30/2009 | 09-16482 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 10/28/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Lamelas, MD, Lisardo J Barrazueta, MD, Gustavo A Tampa General Hospital Bay Area Hospitalists Pickering, MD, Michael Katz, MD, Adam Tampa Lung Specialists Rodriguez, MD, Fernando | |||||
| 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 | $133,299 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $44,267 | ||||||||||||||||||||
| 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. |
This page is not displaying certain sensitive information.
| Department File Number : | M201884135 |
| Claim Number : | 62652 |
| Date Submitted : | 1/19/2018 |
| 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 | Fiordaliza | Toribio | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 6301 Memorial Hwy Ste 104 | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33615 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1602493 08 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME88065 | Hospitalists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Toribio Medical Center | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/13/2017 | 6/28/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Not provided by plaintiff | |||||
| 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 provide appropriate care | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Fall and fractures to skull | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 12/5/2017 | ||||
| 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 | |||||
| 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 | $2,764 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,378 | ||||||||||||||||||||
| 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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. FIORDALIZA TORIBIO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FIORDALIZA TORIBIO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).