| Department File Number : | M202093269 |
| Claim Number : | 388352 |
| Date Submitted : | 8/13/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 95-3014772 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kelly | Andrews | |||
| Street Address | |||||
| 12724 Gran Bay Parkway, W., Suite 400 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32258 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 360 - 3038 | kandrews@thedoctors.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | RICHARD | ROACH | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12109 CR 103 | ||||
| City | State | Zip Code | County | ||
| OXFORD | FL | 34484 | Sumter | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 1633213 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME117782 | Urology - no surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Sumter | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Hospital/Institution | ADVANCED UROLOGY INSTITUTE (LEESBURG) | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Physician's Office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 9/21/2017 | 8/13/2019 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Renal calculus. (kidney stones) | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Left ESWL. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged improper management of anti-coagulant pre-operatively resulting in stroke and neurologic injury. | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 1/17/2020 | 2019-CA-517 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Sumter | 8/10/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| Advanced Urology Institute | |||||
| 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 | |||||
| 8/10/2020 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $500,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $14,415 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $15,633 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $468,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| The case was discussed with the insured and medical experts. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201887179 |
| Claim Number : | 1027026-01 |
| Date Submitted : | 12/3/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 35-0506406 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Lynn | Louthan | |||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Ft Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0778 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Richard | M | Roach | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12109 County Road 103 Ste 2 | ||||
| City | State | Zip Code | County | ||
| Oxford | FL | 34484 | Sumter | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 57588 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME117782 | Surgery - Urological | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Lake | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| LEESBURG REGIONAL MEDICAL CENTER | 100084 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/14/2014 | 6/29/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Right renal calculus | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Right percutaneous Nephrolithotomty | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Failure to rule out stone fragments, failure to request a urinalysis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Urosepsis resulting in kidney failure and dialysis | |||||
| Severity Of Injury | |||||
| Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 12/22/2017 | 35-2016-CA-002140 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Lake | 11/26/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| The Advanced Urology Specialists of FL LLC Tran MD, Dan N Florida Hospital Medical Group Inc dba Lake Surgical Associa Leesburg Regional Medical Center Inc Central Florida Health Inc dba Leesburg Regional Medical Cen Advanced Urology Insitute LLC | |||||
| 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 | |||||
| 11/19/2018 | |||||
| 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 | $25,275 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $12,939 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $125,000 | ||||||||||||||||||||
| 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. RICHARD ROACH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RICHARD ROACH, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).