Department File Number : | M201989159 |
Claim Number : | 1804180104863.00 |
Date Submitted : | 6/25/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PREFERRED PROFESSIONAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-0580977 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teri | Zealand | |||
Street Address | |||||
11605 Miracle Hills Dr Ste 200 | |||||
City | State | Zip | |||
Omaha | NE | 68154 | |||
Phone | Ext | Fax | E-Mail Address | ||
(402) 965 - 3224 | tzealand@coverys.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jenna | Kazil | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 701 Manatee Ave W Ste 105 | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34205 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SPP0046899 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME126038 | Surgery - Vascular |
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 | ||||
Patient's Home | |||||
Name of Institution | Code | ||||
BLAKE MEDICAL CENTER | 100213 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/4/2018 | 9/27/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
fractured leg causing blocked artery | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
tried to stent artery | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
took to other trauma center | |||||
Principal Injury Giving Rise To The Claim | |||||
leg amputation | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 6/14/2019 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
6/14/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $825,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $4,629 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $253 | ||||||||||||||||||||
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 | |||||||||||||||||||||
not applicable. doctor told them he needed higher level of care and they said it would be an EMTALA violation not to take him. |
Updates | |
No updates found. |
Department File Number : | M201988585 |
Claim Number : | 1053656-01 |
Date Submitted : | 9/17/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jenna | L | Kazil | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 701 Manatee Ave W Ste 105 | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34205 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
806462 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME126038 | Surgery - Vascular |
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 | ||||
MANATEE MEMORIAL HOSPITAL | 100035 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/2/2016 | 1/19/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
presented with no pules status post ladder fall from work site | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
fasciotomy, thrombectomy, bypass, debridement | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
failure to timely operate or transfer to another facility that had capacity | |||||
Principal Injury Giving Rise To The Claim | |||||
nerve injury to lower 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 | 4/17/2019 | ||||
Other Defendants Involved in this Claim | |||||
Florida Surgical Clinic LLC | |||||
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 | |||||
4/17/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $9,317 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,513 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
n/a |
Updates | |
No updates found. |
Does Dr. JENNA KAZIL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JENNA KAZIL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).