Department File Number : | M201781163 |
Claim Number : | 9941.150 |
Date Submitted : | 2/9/2017 |
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 | G | Smith | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 530 Tyrone Boulevard N | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33710 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
49588-11 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME90555 | Physicians - 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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Matthew G. Smith, M.D., P.A. | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/12/2009 | 8/19/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Sarcoidosis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
None. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Claimed failure to diagnose Non-Hodgkin's Lymphoma. | |||||
Principal Injury Giving Rise To The Claim | |||||
Delay in ultimately successful Non-Hodgkin's Lymphoma treatment. | |||||
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 | ||||
4/13/2012 | 12-4563-CI-8 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 1/10/2017 | ||||
Other Defendants Involved in this Claim | |||||
Torres, M.D., Arnaldo St. Petersburg Arthritis Center, P.A. | |||||
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 | ||||
Other | Dismissed by Court for Lack of Prosecution | ||||
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 | $44,354 | ||||||||||||||||||||
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 and positive expert review, none deemed necessary. |
Updates | |
No updates found. |
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Does Dr. MATTHEW G SMITH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MATTHEW G SMITH, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).