| Department File Number : | M201576507 |
| Claim Number : | 14-0141-A-12 |
| Date Submitted : | 12/9/2015 |
| 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 | Tamla | Lloyd | |||
| Street Address | |||||
| 4651 Salisbury Road, Suite 410 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32256 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 296 - 2887 | 212 | (904) 296 - 1245 | tlloyd@fdinsurancecompany.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jeffrey | Rose | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1143 NW 64th Terrace | ||||
| City | State | Zip Code | County | ||
| Gainesville | FL | 32605 | Alachua | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MG000594 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME85249 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Alachua | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| NORTH FLORIDA REGIONAL MEDICAL CENTER | 100204 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/2/2012 | 7/8/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient presented to North Florida Regional Medical Center on 2/2/12 to undergo Laparoscopic Gastric Band Placement surgery. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The insured performed Laparoscopic Gastric Band Placement surgery. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| None made | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient presented back to hospital post Laparoscopic Gastric Band Placement with shortness of breath and vomiting. Patient was found to have a large chest pleural effusion and imaging showed leak in esophagus. Consults with pulmonary and infectious disease specialists indicated patient was not a good candidate for immediate repair so patient was managed with antibiotics and chest tube. The patient's clinical condition began to deteriorate and he later expired. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 11/24/2014 | 012014-CA-001850 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Alachua | 11/9/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within 90 days of suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 11/9/2015 | |||||
| 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 | $29,022 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| The circumstances of this case were discussed with the insured and risk management was notified. Risk management discussed the case with the insured. | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201472974 |
| Claim Number : | 11-0051-A-10 |
| Date Submitted : | 12/17/2014 |
| 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 | Linda | D | Collins | ||
| Street Address | |||||
| 4651 Salisbury Road, Suite410 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32256 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 296 - 2887 | 214 | (904) 296 - 1245 | lcollins@fdinsurancecompany.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | JEFFREY | ROSE | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1143 NW 64th Terrace | ||||
| City | State | Zip Code | County | ||
| Gainesville | FL | 32605 | Alachua | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MG000594 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME85249 | Physicians or Surgeons - Major Surgery. NOC classification. | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Alachua | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| NORTH FLORIDA REGIONAL MEDICAL CENTER | 100204 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/23/2010 | 3/9/2011 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient was referred to the insured for complaints of upper abdominal pain. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Da Vinci near-total gastrectomy with revision of gastric bypass. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| None made. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged failure to appropriately and timely follow up, monitor, consult, exam, diagnose and treat post-operative complications. | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 9/27/2012 | 2012-CA-3701 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Alachua | 11/14/2014 | ||||
| Other Defendants Involved in this Claim | |||||
| Surgical Group of Gainesville, P.A. North Florida Regional Medical Center, Inc. | |||||
| 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 | |||||
| 11/14/2014 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $97,500 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $139,675 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Circumstances of this case have been discussed with the insured and Risk Management was notified. | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
Does Dr. JEFFREY ROSE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JEFFREY ROSE, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).