Department File Number : | M201987679 |
Claim Number : | PLFHMGO092589 |
Date Submitted : | 1/23/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Florida Physicians Medical Group | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-3214635 | 800014080 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Linda | Boelke | |||
Street Address | |||||
900 Hope Way | |||||
City | State | Zip | |||
Altamonte Springs | FL | 32714 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 357 - 1313 | linda.boelke@ahss.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Olga | Ivanov | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 2600 Westhall Lane, 4th Floor | ||||
City | State | Zip Code | County | ||
Maitland | FL | 32751 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
8258 - 2017 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME110167 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
FLORIDA HOSPITAL-CELEBRATION HEALTH | 23960017 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/11/2017 | 9/13/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Invasive ductal carcinoma of the right breast. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Elective 07/10/2017 Iodine-125 radioactive seed-placement localization procedure, with the seed placed inaccurately; that was followed by an 07/11/2017 lumpectomy with breast reconstruction procedure, in which the surgeon removed additional breast tissue in the apparent hope that it might include the tumor, seed and clip, but was unsuccessful as postoperative pathology confirmed that only benign tissue was removed. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient was required to undergo additional surgeries to remove the seed, clip and tumor; and because the margins were in fact positive, she then underwent additional cancer treatment, including a mastectomy and radiation therapy. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/21/2018 | ||||
Other Defendants Involved in this Claim | |||||
Welden, James Florida Hospital Physicians Group | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/21/2018 |
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 | $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 | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
Does Dr. OLGA IVANOV, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. OLGA IVANOV, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).