| Department File Number : | M201884272 |
| Claim Number : | 1723933 |
| Date Submitted : | 2/7/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HALLMARK SPECIALTY INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 74-2378996 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Pamela | M | Burke | ||
| Street Address | |||||
| 615 Crescent Executive Ct., Suite 212 | |||||
| City | State | Zip | |||
| Lake Mary | FL | 32746 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (828) 255 - 5181 | (321) 972 - 1022 | pamelaburke@hamlinandburton.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | William | Mazzei | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 14530 S. Military Trail | ||||
| City | State | Zip Code | County | ||
| Delray Beach | FL | 33484 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 77MFP170037 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME69564 | Family Physicians or General Practitioners - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Palm Beach | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Urgent Care Facility | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Express Docs, LLC (urgent care center) | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/21/2016 | 6/1/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient presented with flu like symptoms and was diagnosed with a viral syndrome and discharged to home on Tamiflu, Zantac, Zofran, cough medicine, a Medrol pack and Tylenol. The next day, patient was transported to the ER and diagnosed with pneumonia, adult respiratory distress, and toxic shock syndrome. Patient died. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Insured failed to have a complete blood count test done, a rapid flu test, or a chest x-ray. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Misdiagnosis of viral flu. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Pneumonia. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 1/12/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 1/15/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $43,174 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $5,698 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $225,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Claim settled pre-suit. Economic vs. non-economic damages not calculated. | |||||||||||||||||||||
| Updates | |
| No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. WILLIAM MAZZEI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. WILLIAM MAZZEI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).