| Department File Number : | M202091054 |
| Claim Number : | 68993 |
| Date Submitted : | 1/9/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| MAG MUTUAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 58-1449198 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Markavia | Martin | |||
| Street Address | |||||
| 3535 Piedmont Rd, Building 14, Suite 1000 | |||||
| City | State | Zip | |||
| Atlanta | GA | 30305 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (404) 482 - 4882 | mmartin@magmutual.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | MEDHAT | A | REHEEM | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12900 Cortez Blvd. Suite 104 | ||||
| City | State | Zip Code | County | ||
| Brooksville | FL | 34613 | Hernando | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1601903 13 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME66757 | Anesthesiology - Pain Management | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hernando | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Not in inpatient fascility | ||||
| Name of Institution | Code | ||||
| ADVANCED AMBULATORY SURGERY CENTER, LLC | 14960342 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | LAB | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/17/2017 | 6/6/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| chronic cervical spine/ radicular pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| transforaminal steroid injections in cervical spine. Injection went too far in and air was introduced to the spinal canal | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| alleged failure to properly administer injection | |||||
| Principal Injury Giving Rise To The Claim | |||||
| paralyzing injury to left arm | |||||
| 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 | ||||
| 11/26/2019 | 2018-CA-012321 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 12/17/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Advanced Pain Management Center | |||||
| 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 | |||||
| 12/13/2019 | |||||
| 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 | $72,620 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $27,108 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Risk Management has counseled insured | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201782574 |
| Claim Number : | 50971 |
| Date Submitted : | 7/17/2017 |
| 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 | Medhat | A | Reheem | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12900 Cortez Blvd., Ste. 204 | ||||
| City | State | Zip Code | County | ||
| Brooksville | FL | 34613 | Hernando | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1601903 09 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME66757 | Anesthesiology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hernando | ||||
| 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 | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/29/2010 | 9/16/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Morphine pump removal | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Morphine pump 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 | |||||
| Retained portion of catheter tube | |||||
| 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 | ||||
| 1/14/2015 | CA-15-000087 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hernando | 6/13/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| After court verdict and prior to filing of notice of appeal. | |||||
| Final Method of Claim Disposition | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Directed verdict for defendant. | |||||
| 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 | $116,918 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $40,949 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Risk management has counseled insured | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. MEDHAT A REHEEM, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MEDHAT A REHEEM, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).