Dr. MARY T PENTEL, MD Medical Malpractice Cases, Lawsuits, and Complaints

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Phycicians Practice Address

Dr. MARY T PENTEL, MD

4727 Sunbeam Rd., Ste. 101

Jacksonville, FL

32257

Duval

Court Case # 16-2013-CA-001647

Indemnity Paid: $125,000.00

Medical Malpractice Closed Claims Report

Department File Number :	M201469375
Claim Number :	42658
Date Submitted :	1/24/2014

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	Mary		T	Pentel
Insurer Type		Street Address of Practice
Licensed		4727 Sunbeam Rd., Ste. 101
City		State	Zip Code	County
Jacksonville		FL	32257	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600474 10		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME76473		Dermatology - 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
			F	Duval
City			State	Zip Code

Location where injury occured		Other location where injury occured
Other Outpatient Facility		Southside Dermatology
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
12/8/2010		9/21/2012

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Squamous cell carcinoma in situ of upper right lip.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
MOHS.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure.
Principal Injury Giving Rise To The Claim
Revision surgery, scar.
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
2/13/2013			16-2013-CA-001647
County Suit Filed in			Date of Final Disposition
Duval			1/21/2014
Other Defendants Involved in this Claim
Southside Dermatology
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
12/23/2013

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$125,000

Loss Adjust Expense Paid to Defense Counsel

$30,462

All Other Loss Adjustment Expense Paid

$8,051

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$10,000	$0
Wage Loss	$15,000	$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:

1/24/2014 2:27:48 PM

Reason for Change:

Report updated to reflect Court Document final disposition date of 01/21/14

Field Changed	Former Value	New Value
Date of Final Disposition	23-DEC-13	21-JAN-14

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Court Case # 16-2015-CA-1764

Indemnity Paid: $0.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Department File Number :	M201677653
Claim Number :	47865
Date Submitted :	3/22/2016

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	Mary		T	Pentel
Insurer Type		Street Address of Practice
Licensed		4727 Sunbeam Rd. Ste. 101
City		State	Zip Code	County
Jacksonville		FL	32257	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600474 12		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME76473		Dermatology - Minor Surgery

Florida Office of Insurance Regulation
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
Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
5/7/2013		3/13/2014

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Precancerous lesions on face
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Levulan Kerastick therapy
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Medication in eyes causing irritation
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
10/13/2015			16-2015-CA-1764
County Suit Filed in			Date of Final Disposition
Duval			2/23/2016
Other Defendants Involved in this Claim
Southside Dermatology
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
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?

Indemnity Paid by Insurer on behalf of Insured

Loss Adjust Expense Paid to Defense Counsel

$13,297

All Other Loss Adjustment Expense Paid

$5,197

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

	Incurred to Date	Anticipated
Medical Expense	$0	$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.

This page is not displaying certain sensitive information.

Court Case #

Indemnity Paid: $0.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Department File Number :	M201781377
Claim Number :	52705
Date Submitted :	3/8/2017

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	Mary		T	Pentel
Insurer Type		Street Address of Practice
Licensed		4727 Sunbeam Rd., Ste. 101
City		State	Zip Code	County
Jacksonville		FL	32257	Duval
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 1600474 13		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME76473		Dermatology - Minor Surgery

Florida Office of Insurance Regulation
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
Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
2/26/2015		3/18/2015

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Laser hair removal
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Laser hair removal
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Second degree burns on chin
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information

Date of Suit			Circuit Court Case Number
			*NR
County Suit Filed in			Date of Final Disposition
*NR			2/3/2017
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?

Indemnity Paid by Insurer on behalf of Insured

Loss Adjust Expense Paid to Defense Counsel

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	$0	$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.

*NR: Prior to 04/28/1999 this field was not required in submitted claims.

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Frequently Asked Questions

Does Dr. MARY T PENTEL, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. MARY T PENTEL, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).

Medical Malpractice Cases