Department File Number : | M201472430 |
Claim Number : | 309492 |
Date Submitted : | 10/23/2014 |
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 | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Karin | Stanton | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 731 Parsons Avenue | ||||
City | State | Zip Code | County | ||
Brandon | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0941154 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10472 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BRANDON REGIONAL HOSPITAL | 100243 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/13/2013 | 8/20/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Left sided pelvic pain in 50 year old female, married with 3 children. She also had complaints of post coital bleeding and abnormal pap with uterine fibroids. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Robotic assisted laparoscopic hysterectomy and BSO initiated. When trocar placed the Left iliac vein and right iliac artery were lacerated | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
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 | 10/9/2014 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
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 | $13,049 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,784 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $200,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
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 : | M201678726 |
Claim Number : | 53428 |
Date Submitted : | 6/14/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Karin | K | Stanton | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5002 W. Lemon St. | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33609 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1603217 00 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10472 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BRANDON REGIONAL HOSPITAL | 100243 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/25/2014 | 6/1/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Uterine fibroids | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Hysterectomy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to properly perform procedure | |||||
Principal Injury Giving Rise To The Claim | |||||
Bladder injury | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/24/2016 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
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 | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,564 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Risk management has counseled insured |
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. KARIN STANTON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KARIN STANTON, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).