Department File Number : | M202091105 |
Claim Number : | 71043-A |
Date Submitted : | 1/15/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Daniel | J | Dupre | ||
Street Address | |||||
76 South Laura Street Suite 900 | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4067 | 2001 | (888) 974 - 6458 | ddupre@medmaldirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Miroslav | Uchal | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 11945 San Jose Blvd. Suite 300 | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32223 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707389 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME108409 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dixie | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
ST VINCENT'S MEDICAL CENTER SOUTHSIDE | 23960088 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/6/2017 | 3/23/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Morbid Obesity | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Roux-en-Y bypass procedure | |||||
Diagnostic Code : | 09 | ||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Claim alleged delay in diagnosing multiple complications | |||||
Principal Injury Giving Rise To The Claim | |||||
Multiple post surgical complications | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/28/2019 | 16-2019-CA-003762 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 11/21/2019 | ||||
Other Defendants Involved in this Claim | |||||
CHAPPANO, PAUL | |||||
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 | |||||
11/21/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $67,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $21,568 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,000 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $65,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Intensive case review with defense counsel and experts to optimize patient care and safety. |
Updates | |
No updates found. |
Department File Number : | M201887367 |
Claim Number : | 71043-A |
Date Submitted : | 12/19/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | James | P | Lacey | ||
Street Address | |||||
76 S. Laura Street, Suite 900 | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4068 | (888) 974 - 6458 | claims@medmaldirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Miroslav | Uchal | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2 Shircliff Way, Suite 500 | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32204 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707389 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME108409 | Surgery - General |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT VINCENT'S MEDICAL CENTER | 100040 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/6/2017 | 3/23/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Morbid obesity. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Gastric bypass surgery. | |||||
Diagnostic Code : | 09 | ||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None. | |||||
Principal Injury Giving Rise To The Claim | |||||
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 | 9/26/2018 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
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 | $20,270 | ||||||||||||||||||||
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. |
Updates | |
No updates found. |
Does Dr. MIROSLAV UCHAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MIROSLAV UCHAL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).