Department File Number : | M201887034 |
Claim Number : | F16-001-A-14 |
Date Submitted : | 11/15/2018 |
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 | Diane | M | McNab | ||
Street Address | |||||
9372 Lake Serena Drive | |||||
City | State | Zip | |||
Boca Raton | FL | 33496 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 439 - 0580 | dmcnab@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Harvey | Montijo | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 440 N. State Road 7, Suite 103 | ||||
City | State | Zip Code | County | ||
Royal Palm Beach | FL | 35411 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
GL01000014 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME53688 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WELLINGTON REGIONAL MEDICAL CENTER | 110010 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/28/2014 | 1/12/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient sought Dr. Montijo's care and treatment for an infected prosthetic left knee. Infectious Disease was also involved in the care and treatment. However, plaintiff refused antibiotics for a period of time and numerous surgeries were performed to combat the infection. Unfortunately, the infection led to the patient needing an above the knee amputation. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Left knee revision surgery. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Not applicable. | |||||
Principal Injury Giving Rise To The Claim | |||||
Amputation to the left lower extremity. | |||||
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 | ||||
5/3/2016 | 15th Judicial | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 10/5/2018 | ||||
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 | |||||
11/8/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $195,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $37,022 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $37,022 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured met and conferenced with defense attorney and claims specialist. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201887106 |
Claim Number : | F16-0010-A-14 |
Date Submitted : | 11/21/2018 |
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 | Diane | M | McNab | ||
Street Address | |||||
9372 Lake Serena Drive | |||||
City | State | Zip | |||
Boca Raton | FL | 33496 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 439 - 0580 | dmcnab@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Harvey | Montijo | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 10131 Winter Hill Boulevard, Suite 230 | ||||
City | State | Zip Code | County | ||
West Palm Beach | FL | 33414 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
GL01000014 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME53688 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
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 | ||||
Other | physician office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/28/2014 | 1/12/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought for the care and treatment with this health care provider for an infected prosthetic device. Infectious Disease was also involved in the care and treatment. However, the patient refused antibiotics for a period of time and numerous surgeries were performed to combat the infection. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Numerous surgeries were performed by this health care provider to combat the patient's infection. Unfortunately, the infection led to the patient needing an above the knee amputation. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis. The patient claimed that the revision surgery to address the infection and mobility issues were to aggressive and led to the need for the amputation. This health care provider's care and treatment was supported by a Board Certified Orthopedic Surgeon that conducted his Orthopedic training at Yale and is a Professor of Orthopedic Surgery at the University of Iowa. | |||||
Principal Injury Giving Rise To The Claim | |||||
Above the knee amputation | |||||
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 | ||||
5/9/2016 | 15th Judicial | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 10/5/2018 | ||||
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 | |||||
11/7/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $195,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $39,647 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $39,647 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured met and conferenced with defense counsel and claims specialist. |
Updates | |
No updates found. |
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Does Dr. HARVEY MONTIJO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HARVEY MONTIJO, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).