| Department File Number : | M202092784 |
| Claim Number : | 111372 |
| Date Submitted : | 6/19/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| OPHTHALMIC MUTUAL INSURANCE COMPANY (A R.R.G.) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-3047990 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | Medical Risk Consultant Group | ||||
| Street Address | |||||
| PO Box 140457 | |||||
| City | State | Zip | |||
| Coral Gables | FL | 33114 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 445 - 3040 | (888) 909 - 5304 | MMORENO@MRCG.ORG | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Gary | F | Jaffe | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 18999 Biscayne Boulevard | ||||
| City | State | Zip Code | County | ||
| Aventura | FL | 33180 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| OMC0014165 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME38393 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Dade | ||||
| 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 | ||||
| 6/24/2018 | 8/12/2019 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Dense Cataract OS | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient underwent uneventful cataract surgery OS by insured. Postoperatively, he developed a dense posterior opacification interfering with vision and view to the fundus. He was later diagnosed with a retinal detachment and required surgical repair. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged delay in diagnosis of retinal detachment. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Loss of functional vision OS. | |||||
| 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 | ||||
| 1/31/2020 | 2020-002419-CA-01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 4/20/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within 90 days of suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 6/11/2020 | |||||
| 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 | |||||||||||||||||||||
| Discussion with risk management personnel and medical experts concerning postoperative care. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201574729 |
| Claim Number : | 15-09 |
| Date Submitted : | 5/27/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SOUTH FLORIDA OPHTHALMOLOGICAL SELF INSURING TRUST | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-6628916 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Burt | E | Redlus | ||
| Street Address | |||||
| 19 W. Flagler Street, Suite 711 | |||||
| City | State | Zip | |||
| Miami | FL | 33130 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 374 - 6368 | (305) 371 - 4759 | ber@redluspa.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Gary | Jaffe | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 18999 Biscayne Blvd | ||||
| City | State | Zip Code | County | ||
| North Miami Beach | FL | 33180 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 98 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME38393 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| NORTH MIAMI BEACH SURGICAL CENTER | 14960423 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 8/14/2013 | 2/23/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| mature cataract | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| cataract surgery with insertion of intra ocular lens | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| patient had mature cataract which required surgery | |||||
| Principal Injury Giving Rise To The Claim | |||||
| ruptured posterior capsule leading to nuclear fragments in vitreous | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 5/26/2015 | ||||
| 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 | |||||
| 5/26/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $105,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $2,948 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $500 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| insured advised to carefully document patients understanding of risks of surgery | |||||||||||||||||||||
| 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. GARY F JAFFE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GARY F JAFFE, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).