Medical Malpractice Cases

Medical Malpractice Cases In Polk County Florida

Dr. Ernesto J Perez Medical Malpractice Lawsuits - Court Case # 2004-CA-000139

Indemnity Paid: $3,334,728.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200642110
Claim Number :125676
Date Submitted :8/17/2009
 
Insurer Information
 
Insurer NameCoverage Type
PROASSURANCE CASUALTY COMPANYPrimary
Insurer FEINProfessional License Number
38-2317569 
Insurer Contact Information
TypeEntity Name
EntityProAssurance Indemnity Company, Inc.
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
IndividualErnestoJPerez
Insurer TypeStreet Address of Practice
Licensed1450 6TH ST NE
CityStateZip CodeCounty
WINTER HAVENFL33881-2525Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
MP39846$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME55358Internal Medicine - No Surgery00000

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WINTER HAVEN HOSPITAL100052
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
5/15/20039/12/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Radiating chest pain.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
EKG, lab testss and cardiac enzymes performed which resulted in request for cardiology consult.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis.
Principal Injury Giving Rise To The Claim
Patient suffered an acute MI due to hypertensive cardiovascular disease and expired.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
2/4/20042004-CA-000139
County Suit Filed inDate of Final Disposition
Polk8/21/2006
Other Defendants Involved in this Claim
Winter Haven Hospital, Inc. d/b/a Winter Haven Hospital
Ernesto J. Perez, M.D., L.L.C.
Hetherington, Judith
Star-Med Staffing Services, Inc.
Stage of Legal System at which Settlement was Reached or Award Made
After 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
10/31/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$3,334,728
Loss Adjust Expense Paid to Defense Counsel$204,479
All Other Loss Adjustment Expense Paid$288,448
Injured Person's Total Non-Economic Loss$3,334,728
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$1,092$0
Wage Loss$0$282,392
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Insured has discussed case with insurance company persoonnel, medical experts and defense counsel.
 
Updates
 
 
Date of Change:11/13/2007 9:17:28 AM
Reason for Change:Report updated to reflect indemnity payment following appeal, and to reflect additional costs and legal fees paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid149876265118
Indemnity Paid03334728
Injured Person Total Non-Economic Loss03334728
Settlement Reached01
Amount of Loss Adjustment Expense Paid to Defense Counsel119808198455
Legal System StageAfter court verdict and prior to filing of notice of appeal.After appeal.
 
Date of Change:11/18/2008 2:33:08 PM
Reason for Change:Report updated to reflect additional legal fees and expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid265118300305
Amount of Loss Adjustment Expense Paid to Defense Counsel198455204479
 
Date of Change:8/17/2009 3:42:44 PM
Reason for Change:Report updated to reflect refund of expenses paid.
 
Field ChangedFormer ValueNew Value
All Other Loss Adjustment Expense Paid300305288448

 

 

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Dr. Gregory L Nedurian Medical Malpractice Lawsuits - Court Case # 2010CA-007897

Indemnity Paid: $2,625,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201576102
Claim Number : 278020
Date Submitted : 10/20/2015
 
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 AUDRA M FLOYD
Street Address
13450 WEST SUNRISE BLVD
City State Zip
SUNRISE FL 33323
Phone Ext Fax E-Mail Address
(877) 320 - 0748 3111 (866) 636 - 5421 afloyd@thedoctors.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualGregoryLNedurian
Insurer TypeStreet Address of Practice
Licensed521 Buena Vista Street
CityStateZip CodeCounty
LakelandFL33805Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
0072384$250,000$750,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME90819Surgery - General 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
  
Location of Institutional InjuryOther Location of Institutional Injury
OtherPhysician's Office
Date of OccurrenceDate Reported to Insurer
3/23/20095/18/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient presented to the insured for aortic stent graft to relieve pressure from abdominal aortic aneurysm.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Patient underwent endovascular repair of abdominal aortic aneurysm with the assistance of an interventional radiologist.
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Left side hemiparesis, dementia and partial blindness.
Severity Of Injury
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/21/20102010CA-007897
County Suit Filed inDate of Final Disposition
Polk10/13/2015
Other Defendants Involved in this Claim
Bradshaw, MD, John R
Vailoces, MD, V.J. Tristram
Watson Clinic, LLP
Clark & Daughtrey Medical Group, PA
Stage of Legal System at which Settlement was Reached or Award Made
After notice of appeal is filed or post judgment relief of action is required for recovery.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
10/9/2015
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$2,625,000
Loss Adjust Expense Paid to Defense Counsel$515,000
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
Unknown
 
Updates
 
 
Date of Change:10/20/2015 12:12:01 PM
Reason for Change:Correction made under "Stage of Settlement"
 
Field ChangedFormer ValueNew Value
Legal System StageAfter court verdict and prior to filing of notice of appeal.After notice of appeal is filed or post judgment relief of action is required for recovery.

 

 

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

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Dr. JENNIFER FYNN Medical Malpractice Lawsuits - Court Case # 53-2007-CA-002842

Indemnity Paid: $2,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200952594
Claim Number :PMG-06-AO-56866
Date Submitted :2/17/2009
 
Insurer Information
 
Insurer NameCoverage Type
HUDSON SPECIALTY INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
75-1637737 
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
IndividualJENNIFER FYNN
Insurer TypeStreet Address of Practice
Licensed215 INVERNESS WAY
CityStateZip CodeCounty
WINTER PARKFL33881Orange
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HCP4001905$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME91920Neonatal/Perinatal Medicine 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WINTER HAVEN-REGENCY120010
Location of Institutional InjuryOther Location of Institutional Injury
Labor and Delivery Room 
Date of OccurrenceDate Reported to Insurer
11/30/200612/15/2006
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
VOLVULUS IN NEWBORN
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
ALLEGED FAILURE TO DIAGNOSE VOLVULUS AND ALLEGED DELAY IN TRANSFER
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
DELAY IN TRANSFER AND DELAY IN DIAGNOSIS
Principal Injury Giving Rise To The Claim
MASSIVE BOWEL INFARCTION
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
6/5/200753-2007-CA-002842
County Suit Filed inDate of Final Disposition
Polk2/16/2009
Other Defendants Involved in this Claim
WINTER HAVEN HOSPITAL
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
6/12/2008
 
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$176,206
All Other Loss Adjustment Expense Paid$108,783
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. Johnson P Massey Medical Malpractice Lawsuits - Court Case # 2009CA004078

Indemnity Paid: $1,550,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201680608
Claim Number : 30456/30458
Date Submitted : 12/12/2016
 
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
IndividualJohnsonPMassey
Insurer TypeStreet Address of Practice
Licensed601 Oak Commons Blvd.
CityStateZip CodeCounty
KissimmeeFL34741Osceola
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600938 07$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME42668Cardiovascular Disease - 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
 FPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
HEART OF FLORIDA REGIONAL MEDICAL CENTER100137
Location of Institutional InjuryOther Location of Institutional Injury
Patients' Room 
Date of OccurrenceDate Reported to Insurer
8/18/20075/14/2009
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Sepsis, electrolyte imbalance
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 properly manage potassium
Principal Injury Giving Rise To The Claim
Hyperkalemia, cardiac arrest
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/28/20092009CA004078
County Suit Filed inDate of Final Disposition
Polk11/16/2016
Other Defendants Involved in this Claim
Kundlas, MD, Kulmeet
Bagkus, RN, Bernadette
Ngundam, RN, Edith
Eyesar, RN, Emmanuel
Heart of Florida Regional Medical Center
Cardiovascular Assoc.
Physician Services
Stage of Legal System at which Settlement was Reached or Award Made
After appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Judgment for the plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
11/16/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,550,000
Loss Adjust Expense Paid to Defense Counsel$478,775
All Other Loss Adjustment Expense Paid$263,124
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$3,500$0
Wage Loss$0$0
Other Expenses$8,000$50,000
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. Khurram Javed Medical Malpractice Lawsuits - Court Case # 2015-CA-001483-0000

Indemnity Paid: $1,500,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201680359
Claim Number : 44420/51674
Date Submitted : 11/29/2016
 
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
IndividualKhurram Javed
Insurer TypeStreet Address of Practice
LicensedPO Box 90609
CityStateZip CodeCounty
LakelandFL33801Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1602675 05$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME114009Radiology - interventional 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKELAND REGIONAL MEDICAL CENTER100157
Location of Institutional InjuryOther Location of Institutional Injury
Radiology, Emergency Room 
Date of OccurrenceDate Reported to Insurer
12/8/20124/4/2013
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Thoracic aortic dissection
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
CT
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose thoracic aortic dissection
Principal Injury Giving Rise To The Claim
Hemopericardium and cardiac tamponade
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
4/23/20152015-CA-001483-0000
County Suit Filed inDate of Final Disposition
Polk11/16/2016
Other Defendants Involved in this Claim
Pyles, RN, Angelia P
Roddenberry, RN, Sandra
Emcore, Inc
Florida EM-1 Medical Services
Rodgers, MD, Christopher N
Radiology & Imaging Specialists
Watson Clinic
Baez-Gonzalez, MD, Juan A
Galvez Canto, MD, John G
Lazo De La Vega, MD, Vito A
Lakeland Regional 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
11/3/2016
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,500,000
Loss Adjust Expense Paid to Defense Counsel$61,477
All Other Loss Adjustment Expense Paid$12,126
Injured Person's Total Non-Economic Loss$0
Deductible$100,000
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$9,389$0
Wage Loss$0$1,000,000
Other Expenses$6,576$1,500,000
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Risk management has counseled insured
 
Updates
 
 
Date of Change:11/29/2016 12:05:22 PM
Reason for Change:Report updated to reflect Court Document final disposition date of 11/16/16
 
Field ChangedFormer ValueNew Value
Date of Final Disposition03-NOV-1616-NOV-16

 

 

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Dr. Jack B Thigpen Medical Malpractice Lawsuits - Court Case # 2004CA-003718

Indemnity Paid: $1,500,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200643106
Claim Number :WC/3784-03
Date Submitted :11/10/2006
 
Insurer Information
 
Insurer NameCoverage Type
Watson Clinic LLPPrimary
Insurer FEINProfessional License Number
59-0704934SI
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDee Owens
Street Address
1600 Lakeland Hills Blvd.
CityStateZip
LakelandFL33805
PhoneExtFaxE-Mail Address
(863) 680 - 7620 (863) 616 - 2430dowens@watsonclinic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJackBThigpen
Insurer TypeStreet Address of Practice
Self-Insurer1600 Lakeland Hills Blvd.
CityStateZip CodeCounty
LakelandFL33805Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
39269999$2,000,000*NR
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME26600Surgery - General26540

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Outpatient Facility 
Name of InstitutionCode
LAKELAND REGIONAL MEDICAL CENTER100157
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
8/5/200310/21/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Sepsis
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Hemorrhoidectomy under general anesthesia
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to diagnose and provide timely and adequate treatment for severe, fulminant, overwhelming sepsis.
Principal Injury Giving Rise To The Claim
Death due to severe, fulminant, overwhelming sepsis.
Severity Of Injury
Permanent: Death.

Medical Malpractice Closed Claims Report

 

Legal Information
 
Date of SuitCircuit Court Case Number
9/1/20042004CA-003718
County Suit Filed inDate of Final Disposition
Polk1/9/2006
Other Defendants Involved in this Claim
Randall, Judith L
Watson Clinic LLP
Lakeland Regional 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
1/11/2006
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,500,000
Loss Adjust Expense Paid to Defense Counsel$179,084
All Other Loss Adjustment Expense Paid$102,891
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
Expert reviews called this sepsis a "perfect storm," a similar constellations of events is highly unlikely.
 
Updates
 
No updates found.

 

 

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

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Dr. Stephen V Pappachen Medical Malpractice Lawsuits - Court Case # 23-2010-CA-009122

Indemnity Paid: $1,250,000.00

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M201575063
Claim Number : 34745/34746
Date Submitted : 7/1/2015
 
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
IndividualStephenVPappachen
Insurer TypeStreet Address of Practice
Licensed130 Pablo Street
CityStateZip CodeCounty
LakelandFL33803Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
PSL 1600264 11$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME88723Surgery - Obstetrics - Gynecology 

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKELAND REGIONAL MEDICAL CENTER100157
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
7/29/20098/10/2010
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Menopausal bleeding; adnexal mass
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
LAVH (laparoscopically assisted vaginal hysterectomy) with RSO (right salpingo-oophorectomy) and LOA (lysis of adhesions)
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Alleged failure to recognize complication of procedure
Principal Injury Giving Rise To The Claim
Right ureter injury
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
12/6/201023-2010-CA-009122
County Suit Filed inDate of Final Disposition
Polk6/15/2015
Other Defendants Involved in this Claim
Clark & Daughtrey
Stage of Legal System at which Settlement was Reached or Award Made
After court verdict and prior to filing of notice of appeal.
Final Method of Claim Disposition
Settled by parties
Court DecisionOther
Directed verdict for plaintiff. 
Arbitration
Claim not subject to Arbitration.
Date of Payment
6/3/2015
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,250,000
Loss Adjust Expense Paid to Defense Counsel$183,168
All Other Loss Adjustment Expense Paid$61,600
Injured Person's Total Non-Economic Loss$500,000
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$149,504$0
Wage Loss$0$0
Other Expenses$0$50,000
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. JEFFREY M BARRETT Medical Malpractice Lawsuits - Court Case # 2004CA-853

Indemnity Paid: $1,150,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200848442
Claim Number :60504
Date Submitted :2/4/2008
 
Insurer Information
 
Insurer NameCoverage Type
TIG INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
94-1517098 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualYolanda Burke
Street Address
851 Napa Valley Corp Way Suite N
CityStateZip
NapaCA94558
PhoneExtFaxE-Mail Address
(707) 225 - 3331 (707) 224 - 6858yburke@hudsoninsgroup.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJEFFREYMBARRETT
Insurer TypeStreet Address of Practice
Licensed1600 Lakeland Hills Blvd
CityStateZip CodeCounty
LakelandFL33805Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
39269999$2,000,000*NR
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME48947Surgery - Obstetrics - Gynecology 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKELAND REGIONAL MEDICAL CENTER100157
Location of Institutional InjuryOther Location of Institutional Injury
Labor and Delivery Room 
Date of OccurrenceDate Reported to Insurer
11/23/200110/15/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Labor
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prolongs contraction
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Birth Injury
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
2/20/20042004CA-853
County Suit Filed inDate of Final Disposition
Polk1/14/2008
Other Defendants Involved in this Claim
Watson Clinic
Mammel, James B
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
7/26/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,150,000
Loss Adjust Expense Paid to Defense Counsel$4,852,411
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
unknown at this time
 
Updates
 
No updates found.

 

 

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

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Dr. Jeffrey Barrett Medical Malpractice Lawsuits - Court Case # 2004CA-853-0000-00

Indemnity Paid: $1,150,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200849282
Claim Number :60504
Date Submitted :4/18/2008
 
Insurer Information
 
Insurer NameCoverage Type
Watson Clinic LLPPrimary
Insurer FEINProfessional License Number
59-0704934SI
Insurer Contact Information
TypeFirst NameMILast Name
IndividualDee Owens
Street Address
1600 Lakeland Hills Blvd.
CityStateZip
LakelandFL33805
PhoneExtFaxE-Mail Address
(863) 680 - 7620 (863) 616 - 2430dowens@watsonclinic.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualJeffrey Barrett
Insurer TypeStreet Address of Practice
Self-Insurer1600 Lakeland Hills Blvd.
CityStateZip CodeCounty
LakelandFL33805Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HCF39269999$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME48947Surgery - Obstetrics 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 MPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
LAKELAND REGIONAL MEDICAL CENTER100157
Location of Institutional InjuryOther Location of Institutional Injury
Labor and Delivery Room 
Date of OccurrenceDate Reported to Insurer
11/24/200110/6/2003
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient in full term pregnancy presented in labor
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Emergency C-section
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
No misdiagnosis was actually made.
Principal Injury Giving Rise To The Claim
Hospital staff failed to monitor patient's labor closely to recognize fetal distress and subsequently the deliveringobstetrician performed an emergency C-section.Newborn suffered severe complications and permanent impairment.
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
2/20/20042004CA-853-0000-00
County Suit Filed inDate of Final Disposition
Polk7/26/2007
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
7/26/2007
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$1,150,000
Loss Adjust Expense Paid to Defense Counsel$108,116
All Other Loss Adjustment Expense Paid$37,246
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
Review labor & delivery protocols
 
Updates
 
No updates found.

 

 

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Dr. David Speyerer Medical Malpractice Lawsuits - Court Case # 53-2004-CA-001521

Indemnity Paid: $1,000,000.00

Medical Malpractice Closed Claims Report

 
Department File Number :M200640878
Claim Number :B03033790
Date Submitted :6/2/2006
 
Insurer Information
 
Insurer NameCoverage Type
TIG INSURANCE COMPANYPrimary
Insurer FEINProfessional License Number
94-1517098 
Insurer Contact Information
TypeFirst NameMILast Name
IndividualFinch Carolyn
Street Address
125 S. Wacker Drive, Suite 700
CityStateZip
ChicagoIL60606
PhoneExtFaxE-Mail Address
(312) 267 - 6056 (312) 606 - 9181Carolyn_Finch@tigspecialty.com
 
Insured Information
 
TypeFirst NameMILast Name
IndividualDavid Speyerer
Insurer TypeStreet Address of Practice
Licensed635 First Street North
CityStateZip CodeCounty
Winter HavenFL33881Polk
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
HCF38839904$1,000,000$3,000,000
Profession or BusinessOther Profession or Business
Medical Doctor 
License NumberSpecialty Code & ClassificationCertification Number
ME54224Physicians or Surgeons - major surgery.NOC classification. 

Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First NameMILast NameDate of Birth
    
Street AddressGenderCounty where Injury Occurred
 FPolk
CityStateZip Code
   
Location where injury occuredOther location where injury occured
Hospital Inpatient Facility 
Name of InstitutionCode
WINTER HAVEN HOSPITAL100052
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
4/13/20028/23/2002
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Symptomatic Goiter
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Total thyroidectomy
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Vocal cord paralysis which has led to loss of pulmonary function and inability to speak.Plaintiff also complains of frequent aspiration and coughing.
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
5/27/200453-2004-CA-001521
County Suit Filed inDate of Final Disposition
Polk5/18/2006
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
OtherDismissal as a result of settlement
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/17/2006
 
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$16,873
All Other Loss Adjustment Expense Paid$17,705
Injured Person's Total Non-Economic Loss$0
Deductible$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$63,000$614,376
Wage Loss$157,616$914,035
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
Identify recurrent laryngeal nerves when performing thyroidectomies
 
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.

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