Department File Number : | M201781795 |
Claim Number : | 1016858-05 |
Date Submitted : | 8/17/2017 |
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 | Jerry | Martel | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 8200 SW 117th Ave Ste 110 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33183 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
767124 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME103922 | Gastroenterology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BAPTIST HOSPITAL OF MIAMI | 100008 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/17/2009 | 10/9/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Colo-rectal issues | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Hospitalization with diagnostic testing | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Discharge without completing hematology consult | |||||
Principal Injury Giving Rise To The Claim | |||||
Stroke post discharge | |||||
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 | ||||
9/26/2014 | 13-34027 CA 32 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 4/10/2017 | ||||
Other Defendants Involved in this Claim | |||||
Szomstein, MD, Marcos Ferrer, MD, Jose P Advanced Medical Specialties LLC Baptist Hospital of Miami Inc Marcos Szomstein MD PA Gastro Health PL dba Gastro Health Fein, MD, Steven G Oncology Hemato;ogy Radiation Care LLC dba Advanced Medical | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
During trial, but before court verdict. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
4/10/2017 |
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 | $54,664 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $20,103 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $137,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
n/a |
Updates | ||||||||||
Date of Change: | 8/17/2017 1:49:56 PM | |||||||||
Reason for Change: | ALE UPDATE 8/17/2017 | |||||||||
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Department File Number : | M201472357 |
Claim Number : | 1013181-01 |
Date Submitted : | 2/13/2015 |
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 | Susan | K | Spielman | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0340 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jerry | Martel | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 8200 SW 117th Ave, Ste 110 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33183 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
767124 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME103922 | Gastroenterology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BAPTIST HOSPITAL | 100093 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/12/2011 | 4/23/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Abdominal pain / constipation | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Physical exams; recommended consults | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Allege failure to timely recognize and diagnose small bowel obstruction | |||||
Principal Injury Giving Rise To The Claim | |||||
Massive small bowel necrosis resulting in loss of most of small intestine | |||||
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 | 9/30/2014 | ||||
Other Defendants Involved in this Claim | |||||
Morales MD, Pedro Miami Gastroenterology Associates 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 | |||||
Dropped before Action Filed | |||||
Court Decision | Other | ||||
Other | Not Pursued | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,800 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,282 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
Updates | |||||||
Date of Change: | 2/13/2015 10:47:32 AM | ||||||
Reason for Change: | ALE UPDATE | ||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. JERRY MARTEL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JERRY MARTEL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).