Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M201576388 |
Claim Number : | 0AA957447 |
Date Submitted : | 11/23/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HOMELAND INSURANCE COMPANY OF NEW YORK | Primary | ||||
Insurer FEIN | Professional License Number | ||||
52-1568827 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mike | Clark | |||
Street Address | |||||
199 Scott Swamp Road | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 321 - 2544 | (877) 256 - 5067 | mclark@onebeaconpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mark | D | Jacobson | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 769 County Road 466 | ||||
City | State | Zip Code | County | ||
Lady Lake | FL | 32159 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MPP416011 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67158 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BAYFRONT MEDICAL CENTER | 100032 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/4/2011 | 8/10/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient was admitted to Bayfront Medical Center subsequent to a motor vehicle crash in which she suffered internal injuries. Dr. Jacobson interpreted a computed tomography angiogram of the patient's thorax to investigate a possible descending aortic pseudo-aneurysm. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Dr. Jacobson interpreted a computed tomography angiogram of the patient's thorax to investigate a possible descending aortic pseudo-aneurysm. Dr. Jacobson interpreted the films as showing healing fractures of the right clavicle and several right ribs, interval improvement in bibasilar pulmonary contusions, stable ductus bump, and, ultimately, no appreciable dissection. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
The patient's estate alleged that Dr. Jacobson did not identify a diaphragmatic laceration. | |||||
Principal Injury Giving Rise To The Claim | |||||
During the patient's hospitalization, two prior CT angiograms were obtained and neither suggested any injury to the diaphragm. Dr. Jacobson's care and treatment of the patient was reviewed by nationally-renowned expert radiologist Michael Federle, M.D. of Stanford University School of Medicine, who strongly supported the accuracy of Dr. Jacobson's interpretation of the subject films. The medical examiner's testimony also corroborated that the spleen and stomach did not herniate through the diaphragm until after the CTA, which was interpreted by Dr. Jacobson. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/9/2013 | 13-314CI8 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 11/9/2015 | ||||
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 | |||||
11/12/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $350,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $68,213 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not known at this time |
Updates | |
No updates found. |
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Department File Number : | M201783233 |
Claim Number : | F15-0106-A-14 |
Date Submitted : | 10/2/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FD INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3704679 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jessica | Lance | |||
Street Address | |||||
4651 Salisbury Rd Suite 410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 309 - 8129 | (904) 309 - 8129 | jlance@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mark | Jacobson | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 769 Co Rd 466 | ||||
City | State | Zip Code | County | ||
Lady Lake | FL | 32159 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MS001437 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67158 | Radiology - interventional |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lake | ||||
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 | Physician's office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
11/6/2014 | 5/11/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Radiculopathy, pain in cervical spine | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Injection of an iodine solution prior to an epidural steroid injection | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
alleged allergic reaction to contrast solution | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/24/2016 | 35-2016-CA-000945 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lake | 8/10/2017 | ||||
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 | $121,007 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Case discussed with insured. Risk management will contact if necessary |
Updates | |
No updates found. |
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Does Dr. MARK D JACOBSON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARK D JACOBSON, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).