| Department File Number : | M201886541 |
| Claim Number : | 358532 |
| Date Submitted : | 9/25/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 95-3014772 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kelly | Andrews | |||
| Street Address | |||||
| 12724 Gran Bay Parkway, W., Suite 400 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32258 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 360 - 3038 | kandrews@thedoctors.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | ISRAEL | L | WACKS | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1002 South Old Dixie Highway #206 | ||||
| City | State | Zip Code | County | ||
| Jupiter | FL | 33458 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 069013 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME53751 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Palm Beach | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| JUPITER MEDICAL CENTER | 100253 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/19/2016 | 8/2/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient presented to the ER with lower abdominal pain with urinary frequency since an extensive excision of the perianal skin with an advancement flap. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The insured was called as a GI consult. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient is deceased. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 11/30/2017 | 502017CA01840XXXXMB | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Palm Beach | 8/27/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Sayegh, MD, Bassam Souso, ARNP, Nicole M Bassam Sayegh, MD PA Minimal Invasive Surgery Center, LLC Rodriguez-Figueroa, MD, Jorge Jupiter Medical Center Jupiter Medical Center Physicians Group, Inc. Acute Care Specialists of the Palm Beaches, Inc. Wacks, MD, Israel L Israel L. Wacks, MD PA Pinelli, MD, Donna M Cancer Center of South florida, PLLC Donn M. Pinelli, MD, LC Jupiter Hospitalists, Inc. Jupiter Primary Care Group, Inc. MCCI Group Holdings, LLC Primary Care Associates of North Palm Beach, LLC | |||||
| 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 | |||||
| 8/28/2017 | |||||
| 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 | $28,523 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $23,539 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. | |||||||||||||||||||||
| 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. ISRAEL L WACKS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ISRAEL L WACKS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).