| Department File Number : | M201884936 |
| Claim Number : | 15-0133-A-14 |
| Date Submitted : | 4/4/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-2301054 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Carole | Hussamy | |||
| Street Address | |||||
| 210 osprey Court | |||||
| City | State | Zip | |||
| Vero Beach | FL | 32963 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (772) 205 - 0629 | carole@hussamy.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Omar | Hussamy | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 845 37th Place | ||||
| City | State | Zip Code | County | ||
| Vero Beach | FL | 32960 | Indian River | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MS000375 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME65456 | Surgery - Orthopedic | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Indian River | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Medical office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/21/2014 | 11/18/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Talar fracture | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Inappropriate treatment - placed in walking cast and weight bearing as tolerated | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Failure to diagnose talar fracture | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Avascular necrosis | |||||
| 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 | ||||
| 9/22/2015 | 2015 CA 000703 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Indian River | 12/29/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| 11/9/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $90,000 | ||||||||||||||||||||
| 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. |
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| Department File Number : | M201576228 |
| Claim Number : | 13-0214-A-13 |
| Date Submitted : | 11/3/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| FD INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-3704679 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Tamla | Lloyd | |||
| Street Address | |||||
| 4651 Salisbury Road, Suite 410 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32256 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 296 - 2887 | 212 | (904) 296 - 1245 | tlloyd@fdinsurancecompany.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Omar | Hussamy | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 845 37th PL | ||||
| City | State | Zip Code | County | ||
| Vero Beach | FL | 32960 | Indian River | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MS000375 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME65456 | Surgery - Orthopedic | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Indian River | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/8/2013 | 10/7/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The plaintiff was presented to the insured on 10/22/12 with complaints of left knee pain. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| A MRI was performed on October 29, 2012 and the insured performed a diagnostic arthroscopy of the left knee on November 28, 2012. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| None was made. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The insured allegedly performed an unnecessary left lateral makoplasty procedure on the patient who had no radiological indications and no arthritis in lateral compartment of left knee. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/4/2014 | 2014CA000195 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Indian River | 10/2/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Omar David Hussamy, MD, PA | |||||
| 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 | |||||
| 10/2/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $47,220 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| The circumstances of this case were discussed with the insured and risk management was notified. Risk Management has discussed the case with the insured. | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. OMAR HUSSAMY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. OMAR HUSSAMY, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).