| Department File Number : | M201677439 |
| Claim Number : | 1025806-03 |
| Date Submitted : | 8/11/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 35-0506406 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Susan | K | Spielman | ||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Fort Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0340 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Gregory | J | Panzo | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12 S Park Ave | ||||
| City | State | Zip Code | County | ||
| Apopka | FL | 32703 | Orange | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 716982 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME46534 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Lake | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | The Surgery Center of the Villages | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/1/2014 | 3/25/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Fuchs dystrophy in both eyes, cataracts | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Cataract surgery with multi focal lens | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Should have used mono lens instead of multi focal lens in patient with Fuchs dystrophy | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Blurry left eye 20/100 and blurry right eye 20/30 | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 2/25/2016 | ||||
| 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 | $1,121 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $44 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 8/11/2016 11:27:58 AM | |||||||||
| Reason for Change: | ALE UPDATED 8/11/2016 | |||||||||
| ||||||||||
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. GREGORY J PANZO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GREGORY J PANZO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).