Department File Number : | M201574593 |
Claim Number : | 12-23 |
Date Submitted : | 5/12/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH FLORIDA OPHTHALMOLOGICAL SELF INSURING TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6628916 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Burt | E | Redlus | ||
Street Address | |||||
19 W. Flagler Street | |||||
City | State | Zip | |||
Miami | FL | 33130 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 374 - 6368 | (305) 371 - 4759 | ber@redluspa.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Keith | A | Skolnick | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 850 S Pine Island Rd #A-100 | ||||
City | State | Zip Code | County | ||
Plantation | FL | 33324 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
273 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME80026 | Surgery - Opthalmology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
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 | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/20/2012 | 11/19/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Bi lateral lasik to correct myopia | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Lasik surgery, bilaterally | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
condition post op was termed decentered ablations | |||||
Principal Injury Giving Rise To The Claim | |||||
bilateral irregular astigmatism | |||||
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 | ||||
6/27/2014 | CACE 14-11668 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 5/5/2015 | ||||
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 | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
5/1/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $31,130 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,750 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $133,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
doctor advised to precheck laser and emphasize to patient the risks of surgery |
Updates | |
No updates found. |
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Does Dr. KEITH A SKOLNICK, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KEITH A SKOLNICK, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).