Department File Number : | M201887351 |
Claim Number : | 1053477-01 |
Date Submitted : | 12/19/2018 |
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 | Steven | G | Ortiz | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 14555 Cortez Blvd | ||||
City | State | Zip Code | County | ||
Brooksville | FL | 34613 | Hernando | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
801529 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME118769 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hernando | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
OAK HILL HOSPITAL | 100264 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/16/2016 | 1/17/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Low back stenosis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
lumbar fusion | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
failure to provide conservative treatment & to test bone density & to place pedicle screws appropria | |||||
Principal Injury Giving Rise To The Claim | |||||
worsened back pain and left foot drop | |||||
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 | ||||
5/21/2018 | 18-CA-000558 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hernando | 12/19/2018 | ||||
Other Defendants Involved in this Claim | |||||
West Coast Musculoskeletal Institute PL Access Healthcare Physicians 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 | |||||
12/19/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,311 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,122 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
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. |
Department File Number : | M202092299 |
Claim Number : | 65956 |
Date Submitted : | 4/22/2020 |
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 | Steven | G | Ortiz | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 14690 Spring Hill Dr. Ste. 101 | ||||
City | State | Zip Code | County | ||
Spring Hill | FL | 34609 | Hernando | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1600367 18 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME118769 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hernando | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Not in Institution | ||||
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 | ||||
5/16/2016 | 1/19/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Not available | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Lumbar Fusion | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged improper performance | |||||
Principal Injury Giving Rise To The Claim | |||||
Footdrop | |||||
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 | 4/7/2020 | ||||
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 | |||||
3/20/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $70,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $46,517 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $10,409 | ||||||||||||||||||||
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 | |
No updates found. |
Does Dr. STEVEN G ORTIZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. STEVEN G ORTIZ, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).