| Department File Number : | M201573686 |
| Claim Number : | 59201701 |
| Date Submitted : | 3/5/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PHYSICIANS INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 13-4235490 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Antrine | Long | |||
| Street Address | |||||
| 361 Hillsboro Blvd. | |||||
| City | State | Zip | |||
| Deerfield Beach | FL | 33441 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 788 - 5184 | (954) 944 - 1382 | along@picinsurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | LEOPOLDO | D | VILLANUEVA | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3298 Summit Blvd, Suite 42 | ||||
| City | State | Zip Code | County | ||
| Pensacola | FL | 32503 | Escambia | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 131191 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME23015 | Family Physicians or General Practitioners - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Escambia | ||||
| 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 | ||||
| Other | Patient was not injured. | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/20/2012 | 8/5/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| INSURED TREATED PATIENT FOR PAIN MANAGEMENT FOR BACK AND RIGHT HIP PAIN. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| INSURED TREATED PATIENT FOR PAIN MANAGEMENT FOR BACK AND RIGHT HIP PAIN. PATIENT WAS SEEN EVERY 60 DAYS AND WAS PRESCRIBED XANAX AND HYDROCODONE. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| THE INSURED TREATED THE PATIENT FOR PAIN MANAGMENT ANDBACK AND HIP PAIN. SHE WAS SEEN EVERY 60 DAYS AND THEINSURED PRESCRIBED XANAX AND HYDROCODONE. THE PATIENTWAS LAST SEEN ON 01/20/2012. IN FEB. 2012 THE INSUREDRECEIVED ANOTHER PRESCRIPTION FROM ANOTHER PAINMANAGMENT DOC WHO NOTIFIED THE INSURED THAT THE PATIENTWAS RECEIVING NARCOTICS FROM DIFFERNT PROVIDERS AT THESAME TIME. THE INSURED THEN REFUSED TO PROVIDE MORE MEDSAND THE PATIENT BECAME ANGRY AND DID NOT RETURN. ATREATING PHYSICIAN REPORTED THE MATTER TO THE POLICE.WHEN THE INSURED WAS CONTACTED, BY LAW ENFORECEMNT, HETOLD THE POLICE THAT HE PRESCRIBED NARCOTICS TO THEPATIENT AND DID NOT KNOW THE PATIENT WAS RECEIVEDNARCOTICS FROM ANOTHER PROVIDER, WHICH THE PATIENTADMITTED TO. THE PATIENT HAS NOW FILED A CIVIL SUITALLEGING THE INSURED BREACHED FIDUCIARY DUTY FORDISCLOSING SENSITIVE MEDICAL INFORMATION. | |||||
| Severity Of Injury | |||||
| Emotional Only - Fright, no physical damage | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 7/6/2013 | 2013CA-001759 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Escambia | 1/27/2015 | ||||
| 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 | |||||
| 2/12/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $5,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $12,405 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $218 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| None to report | |||||||||||||||||||||
| 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. LEOPOLDO D VILLANUEVA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. LEOPOLDO D VILLANUEVA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).