Department File Number : | M201680620 |
Claim Number : | 1018283 |
Date Submitted : | 2/20/2017 |
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 | John | M | Szczesny | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 986 Bellflower Court | ||||
City | State | Zip Code | County | ||
Tallahassee | FL | 32312 | Leon | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
692425 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME39651 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Leon | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
2/9/2012 | 3/19/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Referral for psoriatic arthritis, leg Cellulitis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
prescribed Cipo, ordered tapering prednisone, ordered labs | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
failure to prescribe proper antibiotics, treat hyperglycemia and refer to IM and endocrinologist | |||||
Principal Injury Giving Rise To The Claim | |||||
systemic infection, legal blindness | |||||
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 | ||||
5/23/2014 | 14054869 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Leon | 12/7/2016 | ||||
Other Defendants Involved in this Claim | |||||
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 | ||||
Other | settled as result of mediation | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $450,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $63,929 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $34,842 | ||||||||||||||||||||
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: | 2/20/2017 2:44:58 PM | |||||||||
Reason for Change: | ALE UPDATE 2/20/2017 | |||||||||
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Does Dr. JOHN M SZCZESNY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN M SZCZESNY, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).