| Department File Number : | M201782917 |
| Claim Number : | 9941.247 |
| Date Submitted : | 8/28/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-6599936 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Andrew | L | Wallace | ||
| Street Address | |||||
| 341 3rd Street S | |||||
| City | State | Zip | |||
| St. Petersburg | FL | 33701 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Matthew | Couch | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4801 49th Street N. | ||||
| City | State | Zip Code | County | ||
| St. Petersburg | FL | 33709 | Pinellas | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 30688-17 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME102879 | Surgery - General | ||||
| 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 | ||||
| Other Location | St. Petersburg General Hospital | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 8/27/2015 | 3/3/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Large ventral incisional hernia with loss of domain. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Bowel perforation with complicated hernia repair. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Claimed delay in identifying perforation. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Bowel perforation. | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 8/10/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Pinellas Surgical Associates | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 8/10/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $10,262 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Based on physician's review and positive expert review, none deemed necessary. | |||||||||||||||||||||
| 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.
| Department File Number : | M202091799 |
| Claim Number : | 9941.275 |
| Date Submitted : | 3/9/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-6599936 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Andrew | L | Wallace | ||
| Street Address | |||||
| 2727 16th Street N | |||||
| City | State | Zip | |||
| St. Petersburg | FL | 33704 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Matthew | H | Couch | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4801 49th Street North | ||||
| City | State | Zip Code | County | ||
| St. Petersburg | FL | 33709 | Pinellas | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 30688-19 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME102879 | Surgery - General | ||||
| 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 | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| SAINT PETERSBURG GENERAL HOSPITAL | 100180 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/7/2018 | 8/7/2019 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Post-op (hemorrhoidectomy for large thrombosed internal hemorrhoid) bleeding. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Fetus possibly died during Dr. Couch's suture ligation of a single bleed area under general anesthesia 5 days post-initial operation. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| None. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Fetal death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 2/26/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| St. Petersburg General Hospital (nursing care) Pile, M.D., Nadia (OB/GYN) | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within 90 days of suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 2/26/2020 | |||||
| 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 | $13,173 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Based on positive expert review by both a Board-certified surgeon and obstetrician as to the general surgeon addressing the mother's immediate needs, no steps deemed necessary. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201987589 |
| Claim Number : | 15003/11979 |
| Date Submitted : | 1/11/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-6599936 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Andrew | L | Wallace | ||
| Street Address | |||||
| 341 3rd Street S | |||||
| City | State | Zip | |||
| St. Petersburg | FL | 33701 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Matthew | H | Couch | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4801 - 49th Street North | ||||
| City | State | Zip Code | County | ||
| St. Petersburg | FL | 33709 | Pinellas | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 30688-16 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME102879 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Pinellas | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| NORTHSIDE HOSPITAL | 100238 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/15/2015 | 1/21/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Ventral hernia with herniated small bowel loops causing obstruction | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Pt. aspirated during induction of anesthesia in surgical suite | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No known misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Aspiration during anesthesia induction | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 2/6/2017 | 17-000096-CI-20 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Pinellas | 12/3/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| TEAM HEALTH, INC. Florida Gulf-to-Bay Anes. Assoc. Galencare, Inc. d/b/a Northside Hospital Lingam, MD, Sarat | |||||
| 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 | |||||
| 12/17/2018 | |||||
| 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 | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| 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, surgeon not involved in induction of anesthesia | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. MATTHEW COUCH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MATTHEW COUCH, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).