Dr. RENE A CAPULONG, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. RENE A CAPULONG, MD

800 W. Plymouth Avenue

Indemnity Paid: $150,000.00

Insurer Information

Insurer Name				Coverage Type
PHYSICIANS INDEMNITY RISK RETENTION GROUP, INC.				Primary
Insurer FEIN		Professional License Number
20-5245060
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Jaclyn		S	Adler
Street Address
9300 NW 14th Street
City				State	Zip
Pembroke Pines				FL	33024
Phone	Ext	Fax	E-Mail Address
(954) 559 - 3131		(954) 431 - 8388	Jadjuster2@aol.com

Insured Information

Type	First Name		MI	Last Name
Individual	Rene		A	Capulong
Insurer Type		Street Address of Practice
Licensed		800 W. Plymouth Avenue
City		State	Zip Code	County
De Land		FL	32720	Volusia
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PIR100122		$250,000		$750,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME17644		Surgery - General

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			F	Volusia
City			State	Zip Code

Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
MEMORIAL HOSPITAL-WEST VOLUSIA		100045
Location of Institutional Injury		Other Location of Institutional Injury
Operating Suite
Date of Occurrence		Date Reported to Insurer
11/14/2007		1/7/2009

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Increasing pain and discomfort involving the right lower quadrant of her abdomen.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Incision and drainage of the abscessed/infected hematoma along the right lower quadrant of the abdomen.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to identify a perforation.
Principal Injury Giving Rise To The Claim
Patient expired.
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit			Circuit Court Case Number
4/27/2009			2009-12000-CIDL
County Suit Filed in			Date of Final Disposition
Volusia			10/21/2010
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
10/22/2010

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$150,000

Loss Adjust Expense Paid to Defense Counsel

$89,553

All Other Loss Adjustment Expense Paid

Injured Person's Total Non-Economic Loss

$150,000

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

None

Updates

Date of Change:

11/22/2010 6:35:49 PM

Reason for Change:

Revised insurer information

Field Changed	Former Value	New Value
Insurer Name		PHYSICIANS INDEMNITY RISK RETENTION GROUP, INC.

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Does Dr. RENE A CAPULONG, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. RENE A CAPULONG, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).