| Department File Number : | M201573665 |
| Claim Number : | 17237-01 |
| Date Submitted : | 3/3/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PODIATRY INSURANCE COMPANY OF AMERICA | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 58-1403235 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Karen | Kessler | |||
| Street Address | |||||
| 3000 Meridian Blvd., Suite 400 | |||||
| City | State | Zip | |||
| Franklin | TN | 37067 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (615) 371 - 8776 | 2249 | kkessler@picagroup.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Michael | R | Gallina | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 400 So. Tamiami Trail | ||||
| City | State | Zip Code | County | ||
| Venice | FL | 34285 | Polk | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 1PD0013924 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Podiatric Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PO3070 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Polk | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Day Surgery Center | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/24/2009 | 8/29/2011 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Compression neuropathy, left, lower extremity | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Release of common peroneal nerve of leg; release of deep peroneal nerve of dorsum of foot; release of tibial nerve in the tarsal tunnel; release of the medial plantar, lateral plantar, medial calcaneal nerves in the foot; internal neurolysis of the tibial nerve using loupe magnification | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient presented to insured on 03-11-09 with complaints of bilateral pain and swelling in his feet and ankles. Conservative treatment was instituted without success, and patient requested surgical intervention. Post-op, patient relayed that his condition had improved by 90%; however, patient subsequently noted recurrence of his previous condition, which he described as ¿moderately burning.¿ Insured ordered physical therapy, which patient first refused, but shortly thereafter received some modalities. On 10-06-09, patient discontinued all physical therapy appointments to travel to Alabama. In doing so, he only informed the physical therapist directly and not insured that he was discontinuing his post-operative physical therapy. Upon his return from Alabama, patient resumed treatment with insured but complained that he did not want to continue any further post-operative physical therapy even though that was against insured¿s podiatric medical advice. He last saw insured on 11-18-09 and, on that date, reported his condition as ¿moderately burning.¿ Patient claims numbness, tingling and burning and alleges insured performed surgery without appropriate indications, including persistent complaint of severe pain not responsive to medication. | |||||
| 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 | ||||
| 6/19/2012 | 2012CA004171 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Polk | 2/24/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Central Florida Foot & Ankle Center | |||||
| 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 | $127,164 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $981 | ||||||||||||||||||||
| 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 - Specialty code #80993 | |||||||||||||||||||||
| 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.
Does Dr. MICHAEL R GALLINA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MICHAEL R GALLINA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).