Medical Malpractice Cases

Medical Malpractice Cases In Duval County Florida

Dr. Jenny M Whitworth Medical Malpractice Lawsuits - Court Case # 2017-CA-002742

Indemnity Paid: $85,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201884982
Claim Number : 51502
Date Submitted : 5/21/2018
 
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   (404) 842 - 3319 ctschanz@magmutual.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJennyMWhitworth
Insurer TypeStreet Address of Practice
Licensed841 Prudential Dr.
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1603120 01$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME116355Surgery - Gynecology 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
BAPTIST MEDICAL CENTER SOUTH23960052
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
9/5/201411/19/2014
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Increasing menorrhagia and uterine fibroids
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Hysterectomy and bilateral salpingo-oophorectomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Perforated duodenal ulcer with peritonitis
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/27/20172017-CA-002742
County Suit Filed inDate of Final Disposition
Duval4/20/2018
Other Defendants Involved in this Claim
Baptist Medical Center
Baptist SE Gynecological Oncology Assoc.
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
4/3/2018
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$85,000,000
Loss Adjust Expense Paid to Defense Counsel$31,600
All Other Loss Adjustment Expense Paid$7,332
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$588,484$0
Wage Loss$0$400,000
Other Expenses$0$200,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:5/21/2018 3:58:10 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 04/20/18
 
Field ChangedFormer ValueNew Value
Date of Final Disposition03-APR-1820-APR-18

 

 

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Dr. Loren Z Clayman Medical Malpractice Lawsuits - Court Case # 2015-CA-006436

Indemnity Paid: $8,927,189.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885355
Claim Number : 123456A
Date Submitted : 5/21/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualLorenZClayman
Insurer TypeStreet Address of Practice
Licensed2 Shircliff Way Suite 200
CityStateZip CodeCounty
JacksonvilleFL32204Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
123456A$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME23089Surgery - Plastic 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other LocationOffice Surgical Practice
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
OtherOffice Surgical Practice
Date of OccurrenceDate Reported to Insurer
10/24/20145/27/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Elective breast enhancements via placement of saline breast implants.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patients involved in this global settlement underwent at least one elective breast enhancement procedure with placement of saline implants.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Not applicable - elective cosmetic procedures.
Principal Injury Giving Rise To The Claim
After passage of time from their last elective procedure, global plaintiff's alleged concerns with their cosmetic results including concerns over repeat saline implant deflation; a known complication with the use of saline implants.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/8/20152015-CA-006436
County Suit Filed inDate of Final Disposition
Duval3/27/2018
Other Defendants Involved in this Claim
Clayman, MD, Mark 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 DecisionOther
No Court Proceedings. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$8,927,189
Loss Adjust Expense Paid to Defense Counsel$285,152
All Other Loss Adjustment Expense Paid$233,842
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
Several of the claim were reviewed by medial experts who opined that the rendered care by the insured was in accordance with the standard of care and insurance company staff consulted with insured to discuss preventative measures. Patient safety referral is made if applicable.
 
Updates
 
No updates found.

 

 

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Dr. CLIFFORD C ARN Medical Malpractice Lawsuits - Court Case # 2004-CA-002145

Indemnity Paid: $5,550,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200641929
Claim Number :122592
Date Submitted :4/4/2008
 
Insurer Information
 
Insurer NameCoverage Type
PROASSURANCE CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
38-2317569 
Insurer Contact Information
TypeEntity Name
EntityProNational Insurance Company
Street Address
13919 Carrollwood Village Run
CityStateZip
TampaFL33618-2746
PhoneExtFaxE-Mail Address
(813) 969 - 2010 (813) 969 - 2120SNorris@ProAssurance.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualCLIFFORDCARN
Insurer TypeStreet Address of Practice
Licensed5500 Blanding Blvd., Suite 1
CityStateZip CodeCounty
JacksonvilleFL32244Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP35921$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME55583Family Physicians or General Practitioners - No Surgery00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
  
Date of OccurrenceDate Reported to Insurer
2/21/20035/6/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Leukopenia with fever, malaise, sore throat and cough.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Symptomatic care and cough medicine for flu type symptoms.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose pneumococcal pneumonia.
Principal Injury Giving Rise To The Claim
Patient who was diagnosed with pneumococcal pneumonia developed septic shock and died.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
3/19/20042004-CA-002145
County Suit Filed inDate of Final Disposition
Duval4/10/2006
Other Defendants Involved in this Claim
Arn & Aston, P.A.
Stage of Legal System at which Settlement was Reached or Award Made
During appeal.
Final Method of Claim Disposition
Disposed of by Court
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
12/13/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$5,550,000
Loss Adjust Expense Paid to Defense Counsel$162,756
All Other Loss Adjustment Expense Paid$135,229
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
Insured has dicussed case with insurance company personnel, medical experts and defense counsel.
 
Updates
 
 
Date of Change:1/5/2007 4:13:59 PM
Reason for Change:Settlement check was cut on 12/13/06.Also updating expense information.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid82033216496
Indemnity Paid04850000
Settlement Reached01
Amount of Loss Adjustment Expense Paid to Defense Counsel126882160899
 
Date of Change:3/15/2007 11:46:21 AM
Reason for Change:Update to reflect change in status and expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid216496221136
Indemnity Paid48500005550000
Legal System StageAfter court verdict and prior to filing of notice of appeal.During appeal.
Amount of Loss Adjustment Expense Paid to Defense Counsel160899161281
 
Date of Change:5/24/2007 4:01:55 PM
Reason for Change:Update to reflect additional legal fees and expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid221136221529
Amount of Loss Adjustment Expense Paid to Defense Counsel161281162704
 
Date of Change:9/6/2007 12:00:42 PM
Reason for Change:Update to reflect reimburse of expenses by reinsurers.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid221529135229
 
Date of Change:4/4/2008 11:15:23 AM
Reason for Change:Report updated to reflect additional legal fees paid.
 
Field ChangedFormer ValueNew Value
Amount of Loss Adjustment Expense Paid to Defense Counsel162704162756

 

 

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Dr. Randell Powell Medical Malpractice Lawsuits - Court Case # 2001-007974-CA

Indemnity Paid: $4,500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200955170
Claim Number :24485-01
Date Submitted :10/19/2009
 
Insurer Information
 
Insurer NameCoverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INCPrimary
Insurer FEINProfessional License Number
59-6614702 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualOdessa Choice
Street Address
1000 Riverside Avenue, Suite 800
CityStateZip
JacksonvilleFL32204
PhoneExtFaxE-Mail Address
(800) 741 - 37423045(904) 358 - 6728odessa.choice@fpic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualRandell Powell
Insurer TypeStreet Address of Practice
Licensed836 Prudential Dr, Ste 1105
CityStateZip CodeCounty
JacksonvilleFL32207Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
98307$500,000$1,500,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME50450Surgery - Neurology - Including Child80152

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
BAPTIST MEDICAL CENTER AND WOLFSON 100088
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
5/26/19998/8/2001
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Hydrocephalus.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Endoscopic third ventriculostomy.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Severe brain damage.
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
12/7/20012001-007974-CA
County Suit Filed inDate of Final Disposition
Duval9/28/2009
Other Defendants Involved in this Claim
Baptist 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
9/28/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$4,500,000
Loss Adjust Expense Paid to Defense Counsel$276,594
All Other Loss Adjustment Expense Paid$192,325
Injured Person's Total Non-Economic Loss$4,500,000
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
Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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Dr. Mark A Clayman Medical Malpractice Lawsuits - Court Case # 2015-CA-006436

Indemnity Paid: $3,072,811.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201885354
Claim Number : 123456
Date Submitted : 5/21/2018
 
Insurer Information
 
Insurer Name Coverage Type
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) Primary
Insurer FEIN Professional License Number
95-3014772  
Insurer Contact Information
Type First Name MI Last Name
Individual Kelly   Andrews
Street Address
12724 Gran Bay Parkway, W., Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(904) 360 - 3038     kandrews@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualMarkAClayman
Insurer TypeStreet Address of Practice
Licensed2 Shircliff Way Suite 200
CityStateZip CodeCounty
JacksonvilleFL32204Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
123456$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME92516Surgery - Plastic 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Other LocationOffice Surgical Practice
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
OtherOffice Surgical Practice
Date of OccurrenceDate Reported to Insurer
10/24/20145/27/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Elective breast enhancements via placement of saline breast implants.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
The patients involved in this global settlement underwent as least one elective breast enhancement procedure with placement of saline implants.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Not applicable - elective cosmetic procedures.
Principal Injury Giving Rise To The Claim
After passage of time from their last elective procedure, global plaintiff's alleged concerns with their cosmetic results including concerns over repeat saline implant deflation; a known complication with the sue of saline implants.
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/8/20152015-CA-006436
County Suit Filed inDate of Final Disposition
Duval3/27/2018
Other Defendants Involved in this Claim
Clayman, MD, Loren Z
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
 
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$3,072,811
Loss Adjust Expense Paid to Defense Counsel$95,050
All Other Loss Adjustment Expense Paid$77,947
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
Several of the claim were reviewed by medial experts who opined that the rendered care by the insured was in accordance with the standard of care and insurance company staff consulted with insured to discuss preventative measures. Patient safety referral is made if applicable.
 
Updates
 
No updates found.

 

 

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Dr. Shailesh K Gupta Medical Malpractice Lawsuits - Court Case # 2008-CA-015622-MA

Indemnity Paid: $3,013,857.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201056247
Claim Number :06J28658PL-H
Date Submitted :2/1/2010
 
Insurer Information
 
Insurer NameCoverage Type
Univ of FL JHMHC/Jacksonville Self Insurance ProgExcess
Insurer FEINProfessional License Number
59730209 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDanelleHTowater
Street Address
3450 Hull Road, Ste 4358
CityStateZip
GainesvilleFL32611-2735
PhoneExtFaxE-Mail Address
(352) 273 - 7006 (352) 273 - 7287towatdt@shands.ufl.edu
 
Insured Information
 
TypeFirst NameMILast Name
IndividualShaileshKGupta
Insurer TypeStreet Address of Practice
Self-Insurer655 W 8th Street
CityStateZip CodeCounty
JacksonvilleFL32209Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
UFBOT06J-H$5,000,000*NR
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME81086Surgery - Opthalmology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
UNIVERSITY MEDICAL CENTER (DUVAL)100001
Location of Institutional InjuryOther Location of Institutional Injury
Critical Care Unit 
Date of OccurrenceDate Reported to Insurer
10/21/20067/8/2008
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Retinopathy of Prematurity
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Screening premature infant for Retinopathy of Prematurity
Diagnostic Code :360.26
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Bilateral Blindness
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
12/9/20082008-CA-015622-MA
County Suit Filed inDate of Final Disposition
Duval4/29/2009
Other Defendants Involved in this Claim
Grover, Sandeep
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
4/29/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$3,013,857
Loss Adjust Expense Paid to Defense Counsel$0
All Other Loss Adjustment Expense Paid$0
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. Kasra A Nabizadeh Medical Malpractice Lawsuits - Court Case # 16-2012-CA-001205

Indemnity Paid: $2,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M201367039
Claim Number :41731/42481
Date Submitted :6/12/2013
 
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
IndividualKasraANabizadeh
Insurer TypeStreet Address of Practice
Licensed11512 Lake Mead Ave., Suite 513
CityStateZip CodeCounty
JacksonvilleFL32258Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600820 09$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME51611Internal Medicine - Minor Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL JACKSONVILLE100179
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
8/5/20106/26/2012
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Heparin-induced thrombocytopenia
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescribed heparin
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged delay in diagnosis and treatment of heparin-induced thrombocytopenia
Principal Injury Giving Rise To The Claim
Bilateral lower extremity amputations
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
10/29/201216-2012-CA-001205
County Suit Filed inDate of Final Disposition
Duval5/23/2013
Other Defendants Involved in this Claim
Jacksonville Critical Care
Southeast Emergency Consultants
Bohri Orthopaedic & Sports Medicine
Bohsali, MD, Kamal I
Jenkins, MD, Frederick L
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
5/3/2013
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$2,000,000
Loss Adjust Expense Paid to Defense Counsel$24,768
All Other Loss Adjustment Expense Paid$13,722
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$211,497$0
Wage Loss$0$294,755
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:6/12/2013 12:41:42 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 05/23/13
 
Field ChangedFormer ValueNew Value
Date of Final Disposition03-MAY-1323-MAY-13

 

 

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Dr. Safeer A Ashraf Medical Malpractice Lawsuits - Court Case # 2012-CA-002677

Indemnity Paid: $2,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201780852
Claim Number : 41067/39113
Date Submitted : 1/14/2017
 
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.coom
 
Insured Information
 
TypeFirst NameMILast Name
IndividualSafeerAAshraf
Insurer TypeStreet Address of Practice
Licensed9143 Phillips Hwy. Ste. 560
CityStateZip CodeCounty
JacksonvilleFL32256Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600451 10$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME103831Hematology - Minor Surgery 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
BAPTIST HOSPITAL100093
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
2/12/201010/19/2011
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Carotid artery clot
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
No iatrogenic injury
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose and treat clot in left internal carotid artery
Principal Injury Giving Rise To The Claim
Brain injury
Severity Of Injury
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/25/20122012-CA-002677
County Suit Filed inDate of Final Disposition
Duval12/19/2016
Other Defendants Involved in this Claim
Sengstock, MD, Charles
Pennington, MD, John
Naot, MD, Yuval Z
Rosemund, MD, R E
Namen, MD, Andrew M
Baptist Medical Center-South
Fernandez, MD, Kristin
Beabeau, MD, Eugene
ICON
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
12/19/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$2,000,000
Loss Adjust Expense Paid to Defense Counsel$127,582
All Other Loss Adjustment Expense Paid$53,525
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$801,678$9,000,000
Wage Loss$0$1,000,000
Other Expenses$0$1,000,000
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. Duke G Pao Medical Malpractice Lawsuits - Court Case # 16-2015-CA-003619

Indemnity Paid: $2,000,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201783186
Claim Number : 54039
Date Submitted : 9/22/2017
 
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
IndividualDukeGPao
Insurer TypeStreet Address of Practice
Licensed7758 Burnt Oak Trail
CityStateZip CodeCounty
JacksonvilleFL32256Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600004 18$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME82560Radiology - interventional 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
MEMORIAL HOSPITAL JACKSONVILLE100179
Location of Institutional InjuryOther Location of Institutional Injury
Special Procedure Room 
Date of OccurrenceDate Reported to Insurer
10/9/20137/21/2015
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Renal cell carcinoma
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Microwave ablation
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to properly perform procedure
Principal Injury Giving Rise To The Claim
Urinary system injury
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
10/22/201516-2015-CA-003619
County Suit Filed inDate of Final Disposition
Duval9/8/2017
Other Defendants Involved in this Claim
Drs. Mori Bean & Brooks
Memorial Hospital
Neuwave Med. Inc.
Crouse, Marlina
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
9/8/2017
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$2,000,000
Loss Adjust Expense Paid to Defense Counsel$97,267
All Other Loss Adjustment Expense Paid$35,872
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$479,960
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. NAM PHUONG T LU Medical Malpractice Lawsuits - Court Case # 2006-CA-003552

Indemnity Paid: $1,900,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200952973
Claim Number :23787
Date Submitted :3/18/2009
 
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
IndividualNAM PHUONGTLU
Insurer TypeStreet Address of Practice
Licensed11512 Lake Mead Ave. #513
CityStateZip CodeCounty
JacksonvilleFL32256Duval
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600820 03$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
OS8549Internal Medicine - No Surgery 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FDuval
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
SAINT LUKES' HOSPITAL100151
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
10/20/200312/27/2005
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Aseptic meningitis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Brain stem herniation following LP
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to order appropriate administration and monitoring of Dilaudid
Principal Injury Giving Rise To The Claim
Progressive respiratory failure
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
5/12/20062006-CA-003552
County Suit Filed inDate of Final Disposition
Duval2/23/2009
Other Defendants Involved in this Claim
Martinez-Bejar, MD, Lucia M
Stage of Legal System at which Settlement was Reached or Award Made
During trial, but before court verdict.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Directed verdict for plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
2/5/2009
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,900,000
Loss Adjust Expense Paid to Defense Counsel$183,117
All Other Loss Adjustment Expense Paid$183,999
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
Risk management has counseled insured
 
Updates
 
No updates found.

 

 

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