Dr. SAMUEL J GOSS, MD Medical Malpractice Cases, Lawsuits, and Complaints

Phycicians Practice Address

Dr. SAMUEL J GOSS, MD

1879 Nightingale Lane, Ste. L-1

Indemnity Paid: $125,000.00

Insurer Information

Insurer Name				Coverage Type
MAG MUTUAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
58-1449198
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Mercedes			Pressley
Street Address
3535 Piedmont Road NE
City				State	Zip
Atlanta				GA	30305
Phone	Ext	Fax	E-Mail Address
(404) 842 - 5600			MPressley@magmutual.com

Insured Information

Type	First Name		MI	Last Name
Individual	Samuel		J	Goss
Insurer Type		Street Address of Practice
Licensed		1879 Nightingale Lane, Ste. L-1
City		State	Zip Code	County
Tavares		FL	32778	Lake
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
PSL 16030 45		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
OS6997		Cardiovascular Disease - Minor Surgery

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
N/A		000000
Location of Institutional Injury		Other Location of Institutional Injury
Other		Not in inpatient facility
Date of Occurrence		Date Reported to Insurer
1/11/2017		10/12/2018

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Chest Pain
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Coronary Angiogram
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure/delay in referral or consultation
Principal Injury Giving Rise To The Claim
Additional surgery required
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Legal Information

Date of Suit			Circuit Court Case Number
10/8/2019			35-2019-CA-00015-AXX
County Suit Filed in			Date of Final Disposition
Lake			4/20/2020
Other Defendants Involved in this Claim
Cabellero Lopez, Alejandro A
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
4/3/2020

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

$15,409

All Other Loss Adjustment Expense Paid

$3,887

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

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

Risk Management has counseled insured

Does Dr. SAMUEL J GOSS, MD have any medical malpractice cases, lawsuits, or complaints?

Dr. SAMUEL J GOSS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).

Medical Malpractice Cases