Department File Number : | M201472849 |
Claim Number : | 27293-1 |
Date Submitted : | 12/4/2014 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LANCET INDEMNITY RISK RETENTION GROUP INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
26-1479165 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christopher | Teter | |||
Street Address | |||||
2810 West St. Isabel Street Suite 100 | |||||
City | State | Zip | |||
Tampa | FL | 33602 | |||
Phone | Ext | Fax | E-Mail Address | ||
(813) 290 - 8282 | 265 | cteter@lancetindemnity.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | itzhak | Shasha | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1201 N OLIVE AVENUE | ||||
City | State | Zip Code | County | ||
West Palm Beach | FL | 33401 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
LR091111001047 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME44363 | Surgery - General |
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 | ||||
GOOD SAMARITAN HOSPITAL | 110403 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/15/2012 | 4/16/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought treatment for an acute gall bladder that resulted a ruptured aneurysm and permanent dropped foot. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
A laparoscopic colysesectomy was attempted and when placing the trocar an aneurysm was nicked. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The principal injury was a dropped foot. | |||||
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 | ||||
8/8/2013 | 2013CA012613 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 11/4/2014 | ||||
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 | |||||
11/4/2014 |
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 | $57,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurer is unaware of what steps have been taken. |
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.
Department File Number : | M201885493 |
Claim Number : | 360009 |
Date Submitted : | 6/8/2018 |
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 | Itzhak | I | Shasha | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1201 N. Olive Avenue | ||||
City | State | Zip Code | County | ||
Boca Raton | FL | 33401 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1130669 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME44363 | Surgery - General |
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 | ||||
JFK MEDICAL CENTER | 100080 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/28/2017 | 8/28/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought treatment for an infected left shoulder. The final diagnosis was necrotizing faciitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
There was none. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
It is alleged that the insured failed to respond to a consult request and/or failed to come into the hospital to evaluate the patient when he was consulted. | |||||
Principal Injury Giving Rise To The Claim | |||||
Necrotizing Faciitis and complications. | |||||
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 | 5/15/2018 | ||||
Other Defendants Involved in this Claim | |||||
JFK Medical Center Stone, MD, Ross Jimenez, MD, Jesus | |||||
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 | |||||
5/15/2018 |
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 | $10,332 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $10,878 | ||||||||||||||||||||
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 | |||||||||||||||||||||
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.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. |
Does Dr. ITZHAK SHASHA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ITZHAK SHASHA, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).