Medical Malpractice Cases

Medical Malpractice Cases In Columbia County Florida

Dr. Robert B Pendrak Medical Malpractice Lawsuits - Court Case # 04-57-CA

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200433167
Claim Number :17533
Date Submitted :10/14/2004
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertBPendrak
Insurer TypeStreet Address of Practice
Licensed3140 NW MEDICAL CENTER LN STE 110
CityStateZip CodeCounty
LAKE CITYFL32055-4735Columbia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600677 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85025Surgery - Abdominal211567768

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKE CITY MEDICAL CENTER100156
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
7/24/20024/17/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Morbid obesity
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Roux-en-Y gastric bypass
Diagnostic Code :998.0
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose anastomotic leak
Principal Injury Giving Rise To The Claim
Liver disease
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/10/200404-57-CA
County Suit Filed inDate of Final Disposition
Columbia9/29/2004
Other Defendants Involved in this Claim
Lake City Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/29/2004
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$30,727
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$359,600
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$217,300$0
Wage Loss$16,000$372,000
Other Expenses$4,360$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured.
 
Updates
 
No updates found.

 

 

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Dr. Robert B Pendrak Medical Malpractice Lawsuits - Court Case # 03-207-CA

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535439
Claim Number :16798
Date Submitted :11/8/2005
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertBPendrak
Insurer TypeStreet Address of Practice
Licensed3140 NW MEDICAL CENTER LN
CityStateZip CodeCounty
LAKE CITYFL32055-4717Columbia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600677 00$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85025Surgery - Abdominal4102

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKE CITY MEDICAL CENTER100156
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
7/5/200212/16/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Abdominal pain due to adhesions
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Laparotomy with lysis of adhesion
Diagnostic Code :879.2
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to treat complication
Principal Injury Giving Rise To The Claim
Dehiscense of incision, infection, sepsis
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/30/200303-207-CA
County Suit Filed inDate of Final Disposition
Columbia6/8/2005
Other Defendants Involved in this Claim
Lake City Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/6/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,000,000
Loss Adjust Expense Paid to Defense Counsel$32,400
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$400,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$300,000$300,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
 
Date of Change:11/8/2005 2:02:29 PM
Reason for Change:Corrected final disposition date
 
Field ChangedFormer ValueNew Value
Date of Final Disposition06-MAY-0508-JUN-05

 

 

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Dr. Agustin Toruno Medical Malpractice Lawsuits - Court Case # 05-162-CA

Indemnity Paid: $900,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200537754
Claim Number :21234
Date Submitted :10/26/2005
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualAgustin Toruno
Insurer TypeStreet Address of Practice
LicensedPO Box 2913
CityStateZip CodeCounty
Lake CityFL32056Columbia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600068 04$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME21988Anesthesiology68201

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SHANDS AT LAKE SHORE100102
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
12/3/200312/10/2003
 
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
Esophagogastroduodenoscopy (EGD)
Diagnostic Code :789.07
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly monitor and recognize change in status and timely institute corrective measures
Principal Injury Giving Rise To The Claim
Death from anoxic encephalopathy
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/21/200505-162-CA
County Suit Filed inDate of Final Disposition
Columbia9/12/2005
Other Defendants Involved in this Claim
Shands at Lake Shore
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/12/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$900,000
Loss Adjust Expense Paid to Defense Counsel$6,038
All Other Loss Adjustment Expense Paid$1,510
Injured Person's Total Non-Economic Loss$900,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$48,827$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. Donald L McCoy Medical Malpractice Lawsuits - Court Case # 07-329 CA

Indemnity Paid: $882,828.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201058415
Claim Number :SH-PHY-07-69264
Date Submitted :8/30/2010
 
Insurer Information
 
Insurer NameCoverage Type
LEXINGTON INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
25-1149494 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualNancyJThomas
Street Address
9821 Katy Freeway
CityStateZip
HoustonTX77024
PhoneExtFaxE-Mail Address
(713) 935 - 8868 (713) 461 - 8130nancy_thomas@ajg.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualDonaldLMcCoy
Insurer TypeStreet Address of Practice
Licensed130 SW 7th Street
CityStateZip CodeCounty
Vero BeachFL32969Indian River
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
6794385$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Osteopathic Physician 
License NumberSpecialty Code & ClassificationCertification Number
OS5395Emergency Medicine - No Major Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
LAKE CITY MEDICAL CENTER100156
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
2/14/20065/30/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to ED 4 days postpartum with second pregnancy and with sudden onset of shortness of breath
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient was intubated and later given Labetalol.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.Tests were in progress to determine the etiology of SOB.
Principal Injury Giving Rise To The Claim
Alleged delay in intubation in light of patient's decreasing oxygen sats.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/13/200707-329 CA
County Suit Filed inDate of Final Disposition
Columbia8/27/2010
Other Defendants Involved in this Claim
Lake City Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim subject to arbitration, but settlement reached in lieu of award.
Date of Payment
4/6/2010
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$882,828
Loss Adjust Expense Paid to Defense Counsel$105,356
All Other Loss Adjustment Expense Paid$11,816
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Unknown.
 
Updates
 
No updates found.

 

 

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Dr. Robert B Pendrak Medical Malpractice Lawsuits - Court Case # 04-543-CA

Indemnity Paid: $650,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200639213
Claim Number :20066
Date Submitted :1/17/2006
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertBPendrak
Insurer TypeStreet Address of Practice
Licensed3140 NW MEDICAL CENTER LN
CityStateZip CodeCounty
LAKE CITYFL32055-4717Columbia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600677 01$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85025Surgery - Abdominal4102

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKE CITY MEDICAL CENTER100156
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
10/24/20035/25/2004
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Bowel obstruction
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Colon resection, temporary colostomy, and ilesotomy
Diagnostic Code :789.03
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged performance of inappropriate ileostomy procedure
Principal Injury Giving Rise To The Claim
Abdominal infection
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/15/200404-543-CA
County Suit Filed inDate of Final Disposition
Columbia12/6/2005
Other Defendants Involved in this Claim
Lake City Medical Center
Pendrak Surgical Group
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/14/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$650,000
Loss Adjust Expense Paid to Defense Counsel$7,543
All Other Loss Adjustment Expense Paid$4,749
Injured Person's Total Non-Economic Loss$650,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$300,000$100,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. PANKAJKUMAR Y PARIKH Medical Malpractice Lawsuits - Court Case # 05-292-CA

Indemnity Paid: $562,045.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200642437
Claim Number :21903/21904
Date Submitted :10/2/2006
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPANKAJKUMARYPARIKH
Insurer TypeStreet Address of Practice
Licensed820 Prudential Drive Suite 713
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600109 05$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME61626Emergency Medicine - No Major Surgery49548

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Emergency Room 
Name of InstitutionCode
SHANDS AT LAKE SHORE100102
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/10/20044/14/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Lower back pain
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
evaluation
Diagnostic Code :344.6
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose disc herniation and cauda equina syndrome
Principal Injury Giving Rise To The Claim
Disc herniation, cauda equina syndrome
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
7/21/200505-292-CA
County Suit Filed inDate of Final Disposition
Columbia8/31/2006
Other Defendants Involved in this Claim
Emergency Resources Group
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/25/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$562,045
Loss Adjust Expense Paid to Defense Counsel$9,758
All Other Loss Adjustment Expense Paid$577
Injured Person's Total Non-Economic Loss$925,000
Deductible$362,955
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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Dr. Keith G Chisholm Medical Malpractice Lawsuits - Court Case # 11-389 CA

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201265208
Claim Number :09G36750PL
Date Submitted :10/24/2012
 
Insurer Information
 
Insurer NameCoverage Type
Univ of FL JHMHC Self-Insurance ProgramPrimary
Insurer FEINProfessional License Number
59-600205 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualMerryCReid
Street Address
2124 NE Waldo Road, Suite 3100
CityStateZip
GainesvilleFL32609
PhoneExtFaxE-Mail Address
(352) 273 - 7006 (352) 273 - 5424REIDM@ufl.edu
 
Insured Information
 
TypeFirst NameMILast Name
IndividualKeithGChisholm
Insurer TypeStreet Address of Practice
Self-Insurer1600 S. W. Archer Road
CityStateZip CodeCounty
GainesvilleFL32610Alachua
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
UFBOT09G$2,000,000*NR
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME83998Surgery - General 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FAlachua
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SHANDS AT LAKE SHORE100102
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/27/20101/24/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Abdominal pain, nausea
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Gastrectomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Afferent loop obstruction, sepsis, and temporary renal failure
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage.Recovery delayed.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/29/201111-389 CA
County Suit Filed inDate of Final Disposition
Columbia3/26/2012
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
3/26/2012
 
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$13,934
All Other Loss Adjustment Expense Paid$7,439
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Assessment of treatment with physician
 
Updates
 
No updates found.

 

 

*NR:Prior to 04/28/1999 this field was not required in submitted claims.

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Dr. Ernest P De Leon Medical Malpractice Lawsuits - Court Case # 07-373-CA

Indemnity Paid: $500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200955522
Claim Number :25491
Date Submitted :1/12/2010
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualErnestPDe Leon
Insurer TypeStreet Address of Practice
Licensed4225 NW American Lane
CityStateZip CodeCounty
Lake CityFL32055Columbia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600028 08$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME61518Family Physicians or General Practitioners - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
4/22/20054/25/2007
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Kidney disease
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosing kidney disease
Principal Injury Giving Rise To The Claim
Kidney disease
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
8/29/200707-373-CA
County Suit Filed inDate of Final Disposition
Columbia10/28/2009
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
9/24/2009
 
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$48,897
All Other Loss Adjustment Expense Paid$41,670
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$418,137$27,000,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:1/12/2010 11:53:43 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 10/2/09
 
Field ChangedFormer ValueNew Value
Date of Final Disposition30-OCT-0928-OCT-09

 

 

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Dr. Paul J Schilling Medical Malpractice Lawsuits - Court Case # 14-CA-000190

Indemnity Paid: $500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201782179
Claim Number : 47159
Date Submitted : 6/23/2017
 
Insurer Information
 
Insurer Name Coverage Type
MAG MUTUAL INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
58-1449198  
Insurer Contact Information
Type Entity Name
Entity MAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
City State Zip
Orlando FL 32819
Phone Ext Fax E-Mail Address
(407) 370 - 3813   (407) 370 - 2247 ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualPaulJSchilling
Insurer TypeStreet Address of Practice
Licensed7000 NW 11th Place
CityStateZip CodeCounty
GainesvilleFL32605Alachua
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600638 11$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME64027Radiology - interventional 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other Outpatient FacilityInvision Imaging Center
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
9/29/201112/24/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Renal mass
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Radiology studies
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged improper diagnosis of metastatic renal cell carcinoma to thoracic spine
Principal Injury Giving Rise To The Claim
Unnecessary chemo/radiation resulting in nerve injury
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/20/201414-CA-000190
County Suit Filed inDate of Final Disposition
Columbia5/25/2017
Other Defendants Involved in this Claim
Khan, MD, Waseem
Baker, MD, Mark A
Doctors Radiology of Gainesville
Cancer Care of N. Florida
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/1/2017
 
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$98,250
All Other Loss Adjustment Expense Paid$42,810
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$590,000$250,000
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:6/23/2017 10:16:05 AM
Reason for Change:Report updated to reflect Court Document final disposition date of 5/25/17
 
Field ChangedFormer ValueNew Value
Date of Final Disposition01-MAY-1725-MAY-17

 

 

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Dr. Robert B Pendrak Medical Malpractice Lawsuits - Court Case # 04-66-CA

Indemnity Paid: $495,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200535469
Claim Number :18439
Date Submitted :6/10/2005
 
Insurer Information
 
Insurer NameCoverage Type
MAG MUTUAL INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
58-1449198 
Insurer Contact Information
TypeEntity Name
EntityMAG Mutual Insurance Company
Street Address
8427 South Park Circle Suite 130
CityStateZip
OrlandoFL32819
PhoneExtFaxE-Mail Address
(407) 370 - 3813 (407) 370 - 2247cwehner@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRobertBPendrak
Insurer TypeStreet Address of Practice
Licensed3140 NW MEDICAL CENTER LN STE 110
CityStateZip CodeCounty
LAKE CITYFL32055-4735Columbia
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600677 01$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME85025Surgery - Abdominal4102

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FColumbia
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKE CITY MEDICAL CENTER100156
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
8/23/20029/12/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Acute cholecystitis and cholelithiasis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Cholecystectomy
Diagnostic Code :577.1
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged negligence in performance of cholecystectomy
Principal Injury Giving Rise To The Claim
Death
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/17/200404-66-CA
County Suit Filed inDate of Final Disposition
Columbia6/7/2005
Other Defendants Involved in this Claim
Lake CIty Medical Center
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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/7/2005
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$495,000
Loss Adjust Expense Paid to Defense Counsel$16,719
All Other Loss Adjustment Expense Paid$0
Injured Person's Total Non-Economic Loss$495,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$150,000$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk Management has counseled insured
 
Updates
 
No updates found.

 

 

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