Dr. KYLE P ETZKORN, MD Medical Malpractice Cases, Lawsuits, and Complaints

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Phycicians Practice Address

Dr. KYLE P ETZKORN, MD

3728 PHILLIPS HWY

JACKSONVILLE, FL

32207

Duval

Court Case # 16-2012-CA-008958

Indemnity Paid: $150,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M201471412
Claim Number :	41024
Date Submitted :	7/25/2014

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	Kyle		P	Etzkorn
Insurer Type		Street Address of Practice
Licensed		4800 Belfort Rd., Ste. 300
City		State	Zip Code	County
Jacksonville		FL	32256	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600542 10		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME71063		Gastroenterology - Minor Surgery

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	Duval
City			State	Zip Code

Location where injury occured		Other location where injury occured
Other Outpatient Facility		Jacksonville Center for Endoscopy
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Special Procedure Room
Date of Occurrence		Date Reported to Insurer
8/18/2010		4/17/2012

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Tubulovillous polyp
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to report correct location of polyp during colonoscopy
Principal Injury Giving Rise To The Claim
Removal of excessive portion of colon
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
8/5/2012			16-2012-CA-008958
County Suit Filed in			Date of Final Disposition
Duval			7/16/2014
Other Defendants Involved in this Claim
Crump, MD, John Borland Groover Clinic North Florida Surgeons
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
7/16/2014

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$150,000

Loss Adjust Expense Paid to Defense Counsel

$64,691

All Other Loss Adjustment Expense Paid

$26,532

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$100,000	$0
Wage Loss	$0	$0
Other Expenses	$0	$0

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Risk management has counseled insured

Updates

No updates found.

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Court Case # 16-2004-CA-002796

Indemnity Paid: $50,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M200534626
Claim Number :	16588
Date Submitted :	11/7/2005

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	cwehner@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	Kyle		P	Etzkorn
Insurer Type		Street Address of Practice
Licensed		3728 PHILLIPS HWY
City		State	Zip Code	County
JACKSONVILLE		FL	32207	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600542 00		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME71063		Gastroenterology - Minor Surgery		02846

Medical Malpractice Closed Claims Report

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Duval
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
BAPTIST MEDICAL CENTER - BEACHES		100117
Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
4/25/2002		11/7/2002

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Dementia, inability to swallow
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insertion/reinsertion of PEG tube
Diagnostic Code :		DC290.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to perform endoscopy to confirm correct PEG positioning on reinsertion.
Principal Injury Giving Rise To The Claim
Sepsis, laparotomy, respiratory complications.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage.Recovery delayed.

Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
4/13/2004			16-2004-CA-002796
County Suit Filed in			Date of Final Disposition
Duval			8/12/2005
Other Defendants Involved in this Claim
Baptist Medical Center Gatien, D.O., Lionel J
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
2/10/2005

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$50,000

Loss Adjust Expense Paid to Defense Counsel

$15,073

All Other Loss Adjustment Expense Paid

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$25,000	$0
Wage Loss	$0	$0
Other Expenses	$0	$0

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Risk management has counseled insured.

Updates

Date of Change:

11/7/2005 3:16:36 PM

Reason for Change:

Corrected final disposition date

Field Changed	Former Value	New Value
Date of Final Disposition	10-FEB-05	12-AUG-05

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Frequently Asked Questions

Does Dr. KYLE P ETZKORN, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. KYLE P ETZKORN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).