Dr. JAY B MANDELKORN, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. JAY B MANDELKORN, MD

820 Prudential Drive Suite 615

Indemnity Paid: $875,000.00

Insurer Information

Insurer Name				Coverage Type
MAG MUTUAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
58-1449198
Insurer Contact Information
Type		Entity Name
Entity		MAG MUTUAL INSURANCE COMPANY
Street Address
8427 South Park Circle Suite 130
City				State	Zip
Orlando				FL	32819
Phone	Ext	Fax	E-Mail Address
(407) 370 - 3813		(407) 370 - 2247	cwehner@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	Jay		B	Mandelkorn
Insurer Type		Street Address of Practice
Licensed		820 Prudential Drive Suite 615
City		State	Zip Code	County
Jacksonville		FL	32207	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600328 03		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME39834		Cardiovascular Disease - Minor Surgery		3503

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	Duval
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
MEMORIAL HOSPITAL JACKSONVILLE		100179
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
1/14/2003		9/15/2003

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
New onset mid-chest pain
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Cardiology work-up, observation
Diagnostic Code :		441.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to proeprly interpret echocardiogram and timely recommend appropriate studies
Principal Injury Giving Rise To The Claim
Acute aortic event
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit			Circuit Court Case Number
2/7/2004			16-2004-CA-000728
County Suit Filed in			Date of Final Disposition
Duval			5/18/2006
Other Defendants Involved in this Claim
Wolford, MD, Thomas T Hall, ARNP, Linda C Forster, III, MD, John G Southern Heart Group Jacksonville Emergency Consultants Memorial Hospital Jacksonville
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
5/16/2006

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$875,000

Loss Adjust Expense Paid to Defense Counsel

$48,885

All Other Loss Adjustment Expense Paid

$19,394

Injured Person's Total Non-Economic Loss

$875,000

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Risk management has counseled insured

Updates

Date of Change:

2/16/2007 9:18:53 AM

Reason for Change:

Report updated to reflect correct indemnity payment of $875,000

Field Changed	Former Value	New Value
Injured Person Total Non-Economic Loss	900000	875000
Indemnity Paid	900000	875000

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Does Dr. JAY B MANDELKORN, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. JAY B MANDELKORN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).