Department File Number : | M201576141 |
Claim Number : | 329996 |
Date Submitted : | 10/22/2015 |
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 | AUDRA | M | FLOYD | ||
Street Address | |||||
13450 WEST SUNRISE BLVD | |||||
City | State | Zip | |||
SUNRISE | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | 3111 | (866) 636 - 5421 | afloyd@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jeffrey | Wasserman | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 8374 Market Street, Suite #502 | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34202 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0074118 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS8900 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Manatee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Radiology Department | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/11/2013 | 5/12/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented with right leg pain. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Right above the knee amputation. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Above the knee amputation of the right leg. | |||||
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 | 10/15/2015 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
10/9/2015 |
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 | $15,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
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 : | M201676954 |
Claim Number : | 328192 |
Date Submitted : | 1/28/2016 |
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 | AUDRA | M | FLOYD | ||
Street Address | |||||
13450 WEST SUNRISE BLVD | |||||
City | State | Zip | |||
SUNRISE | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | 3111 | (866) 636 - 5421 | afloyd@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jeffrey | Wasserman | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 8374 Market Street, Ste. 502 | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34202 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0074118 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS8900 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Manatee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
LAKEWOOD RANCH MEDICAL CENTER | 23960046 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/14/2014 | 3/18/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to emergency department with signs and symptoms of a stroke. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent drug screens and CT. Insured read CT scan as negative for signs of a stroke. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to accurately interpret CT angiogram to identify findings consistent with an acute middle cerebral artery infarct. | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 1/22/2016 | ||||
Other Defendants Involved in this Claim | |||||
Bradenton Neurology, Inc. Broderick, RN, Tara Cline, RN, Janet Curry, RN, Rita Deal, PA, John Hall, Mitchell F Howard, RN, Melissa Katz, MD, Robert Manatee Memorial Hospital McElveen, MD, Alvin W Paragon Emergency Services Scro, RN, Joelle Universal Health Services, Inc. Wellington Regional Medical Center | |||||
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 | |||||
1/8/2016 |
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 | $27,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
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 : | M201574677 |
Claim Number : | 320763 |
Date Submitted : | 5/19/2015 |
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 | Tiffany | D | Taylor | ||
Street Address | |||||
13450 West Sunrise Blvd | |||||
City | State | Zip | |||
Sunrise | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | TTaylor@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jeffrey | Wasserman | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 8374 Market Street, Box 502 | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34202 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0074118 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS8900 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Manatee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/20/2012 | 7/23/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the ER with stroke symptons. The patient remains in a "locked in" neurological state. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
A CT scan of the brain. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged misrepresentation of radiologic studies. | |||||
Severity Of Injury | |||||
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/3/2015 | 412015 CA 000438 CAA | ||||
County Suit Filed in | Date of Final Disposition | ||||
Manatee | 4/30/2015 | ||||
Other Defendants Involved in this Claim | |||||
Martinez., M.D., Hector A Paragon Emergency Services, Inc. Thomas, M.D., John L John, M.D., Bijoy K Cape Coral Hospitalists, Inc. Gonzalez, M.D., Ralph F Bradenton Neurology, Inc. Bilodeau, M.D., Richard G Manatee Lakewood Radiology Associates, LLC Manatee Memorial Hospital, L.P.dba Lakewood Ranch Med Center Wellington Regional Medical Center, Inc. Universal Health Services, 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 | |||||
4/29/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $249,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $26,791 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $249,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Unknown |
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. JEFFREY WASSERMAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JEFFREY WASSERMAN, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).