| Department File Number : | M201677217 |
| Claim Number : | 1013557-01 |
| Date Submitted : | 8/11/2016 |
| 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 | Susan | K | Spielman | ||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Fort Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0340 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Victor | G | Ghobrial | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 250 2nd Street East, Ste 3A | ||||
| City | State | Zip Code | County | ||
| Bradenton | FL | 34208 | Manatee | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 692730 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME87238 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Manatee | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| MANATEE MEMORIAL HOSPITAL | 100035 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/19/2011 | 5/3/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Abdominal pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Hospitalization | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Improper treatment | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 12/23/2013 | 2012 CA 004701AX | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Manatee | 2/10/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Dewitt MD, Derek Associates In Respiratory Medicine PA | |||||
| 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 | |||||
| 2/8/2016 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $91,268 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $57,692 | ||||||||||||||||||||
| 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 | ||||||||||
| Date of Change: | 8/11/2016 9:24:42 AM | |||||||||
| Reason for Change: | ALE UPDATED 8/11/2016 | |||||||||
| ||||||||||
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| Department File Number : | M201676902 |
| Claim Number : | 1018491-01 |
| Date Submitted : | 1/21/2016 |
| 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 | Susan | K | Spielman | ||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Fort Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0340 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Victor | G | Ghobrial | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 250 2nd Street East, Ste 3A | ||||
| City | State | Zip Code | County | ||
| Bradenton | FL | 34208 | Manatee | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 692730 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME87238 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Manatee | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| MANATEE MEMORIAL HOSPITAL | 100035 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Critical Care Unit | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/13/2010 | 4/2/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Abdominal pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Hospitalization | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Breach of confidentiality | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Emotional distress | |||||
| Severity Of Injury | |||||
| Emotional Only - Fright, no physical damage | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/26/2014 | 41 2012CA007507 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Manatee | 1/21/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Associates in Respiratory Medicine PA | |||||
| 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 | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Other | Dismissal | ||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $12,545 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $292 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. VICTOR G GHOBRIAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. VICTOR G GHOBRIAL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).