| Department File Number : | M201886980 |
| Claim Number : | FL0527 |
| Date Submitted : | 11/12/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 74-3129288 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Yvette | de la Morena | |||
| Street Address | |||||
| 1250 S. Pine Island Road Suite 300 | |||||
| City | State | Zip | |||
| Plantation | FL | 33324 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 923 - 1900 | ymorena@hugroups.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Peter | S | Dovgan | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 655 S. Apollo Blvd., Suite 2 | ||||
| City | State | Zip Code | County | ||
| Melbourne | FL | 32901 | Brevard | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 312-000 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME79594 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Brevard | ||||
| 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 | Physicians Office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/6/2016 | 3/14/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Treatment was sought for continued problems with typical severe claudication | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Alleged failure to recognize the iliac leak caused by a perforation during procedure | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged failure to recognize the iliac leak caused by a perforation during procedure had to be fixed resulting in multiple surgical procedures and extended hospitalization | |||||
| 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 | 10/29/2018 | ||||
| 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 | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 11/7/2018 | |||||
| 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 | $25,146 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussed with insured. | |||||||||||||||||||||
| 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.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Does Dr. PETER S DOVGAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PETER S DOVGAN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).