Department File Number : | M201989573 |
Claim Number : | MS5009998-01 |
Date Submitted : | 8/8/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL SECURITY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
56-1600780 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kristen | Janicek | |||
Street Address | |||||
700 Spring Forest Road | |||||
City | State | Zip | |||
Raleigh | NC | 27609 | |||
Phone | Ext | Fax | E-Mail Address | ||
(919) 878 - 7617 | kristen.janicek@curi.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | E | Mallory | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 110 Longwood Avenue | ||||
City | State | Zip Code | County | ||
Rockledge | FL | 32955 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EG118876 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS5771 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
WUESTHOFF MEMORIAL HOSPITAL, INC. | 100092 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/10/2015 | 4/15/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
right non-displaced tibial plateau fracture | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged failure to arrange orthopedic surgery follow up within eight hours after discharge from emergency room. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
compartment syndrome | |||||
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 | ||||
9/14/2016 | 05-2016-CA-041208 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 7/15/2019 | ||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $367,865 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $17,208 | ||||||||||||||||||||
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 | |||||||||||||||||||||
none |
Updates | |
No updates found. |
Department File Number : | M201678632 |
Claim Number : | 1524106 Panek Mallor |
Date Submitted : | 6/6/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL SECURITY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
56-1600780 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | Hamlin & Burton Liability Management, Inc. | ||||
Street Address | |||||
5000 US Highway 17, Suite 18-262 | |||||
City | State | Zip | |||
Orange Park | FL | 32003 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 284 - 3462 | (321) 972 - 0121 | paultucker@hamlinandburton.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | George | E | Mallory | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 301 N. Atlantic Avenue, Suite 504 | ||||
City | State | Zip Code | County | ||
Cocoa | FL | 32931 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP200001 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS5771 | Emergency Medicine - No Major Surgery | 0435 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
WUESTHOFF MEMORIAL HOSPITAL | 23960034 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/23/2013 | 12/12/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Chronic Back Pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No intraoperative or other injury caused by or during rendering of services. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Plaintiff alleges physicians failed to recognize the development of a spinal abscess. | |||||
Principal Injury Giving Rise To The Claim | |||||
Thoracic Spinal Abscess | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/16/2015 | 2015-CA-33507 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 4/29/2016 | ||||
Other Defendants Involved in this Claim | |||||
Ehlenberger, Charles Page, Ralph Vega, Jose Matuk, Fariuz | |||||
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 | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Other | Plaintiff attorney withdrew | ||||
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 | $37,762 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,149 | ||||||||||||||||||||
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 counseled parties |
Updates | |
No updates found. |
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Does Dr. GEORGE E MALLORY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GEORGE E MALLORY, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).