Department File Number : | M201473081 |
Claim Number : | 46699 |
Date Submitted : | 1/16/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ratnasabapathy | Sivasekaran | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2810 SE 3rd Court | ||||
City | State | Zip Code | County | ||
Ocala | FL | 34471 | Marion | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1602687 03 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME90344 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Marion | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MUNROE REGIONAL MEDICAL CENTER | 100062 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/8/2011 | 11/18/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Thoracic spine abscess | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No iatrogenic injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to timely diagnose and treat thoracic spine abscess | |||||
Principal Injury Giving Rise To The Claim | |||||
Paraplegia | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/2/2014 | 2014-CA-000781 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Marion | 1/9/2015 | ||||
Other Defendants Involved in this Claim | |||||
Villacastin, MD, Alex Patel, MD, Sanjay A Cairo Lavado, MD, Javier B W. Fl. Medical Assoc. SKS Medical Munroe Regional | |||||
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 | |||||
12/11/2014 |
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 | $10,702 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,534 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |||||||
Date of Change: | 1/16/2015 12:21:31 PM | ||||||
Reason for Change: | Report updated to reflect Court Document final disposition date of 01/09/15 | ||||||
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Department File Number : | M201884577 |
Claim Number : | 56378 |
Date Submitted : | 3/13/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (404) 842 - 3319 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ratnasabapathy | Sivasekaran | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2810 SE 3rd Court | ||||
City | State | Zip Code | County | ||
Ocala | FL | 34471 | Marion | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1602687 05 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME90344 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Marion | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Nursing Home | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/18/2015 | 1/27/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pulmonary embolism | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No iatrogenic injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to properly supervise ARNP | |||||
Principal Injury Giving Rise To The Claim | |||||
Pulmonary embolism | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/17/2017 | 17-1480-CAB | ||||
County Suit Filed in | Date of Final Disposition | ||||
Marion | 2/15/2018 | ||||
Other Defendants Involved in this Claim | |||||
Carameros, ARNP, Jeffrey Timber Ridge Nursing & Rehab Center | |||||
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 | |||||
2/15/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $125,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $24,399 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,100 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |
No updates found. |
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Does Dr. RATNASABAPATHY SIVASEKARAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RATNASABAPATHY SIVASEKARAN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).