| Department File Number : | M201679787 |
| Claim Number : | 108412 |
| Date Submitted : | 9/27/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| OPHTHALMIC MUTUAL INSURANCE COMPANY (A R.R.G.) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-3047990 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | Medical Risk Consultant Group | ||||
| Street Address | |||||
| PO Box 431271 | |||||
| City | State | Zip | |||
| Miami | FL | 33243-1271 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 668 - 0432 | (305) 668 - 0433 | MMORENO@MRCG.ORG | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shareen | Greenbaum | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 11011 Sheridan Street | ||||
| City | State | Zip Code | County | ||
| Hollywood | FL | 33026 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0012217 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME97538 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/15/2015 | 10/9/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Age-Related Macular Degeneration of the Retina | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient with AMD sought evaluation for confirmation of diagnosis prior to undergoing experimental treatment by another healthcare provider; the treatment occurred at another facility NOT at the physician's office NOR by this physician. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis made; the patient did have AMD. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Loss of vision, both eyes. | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 8/25/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Perez, Alejandro BioHeart, Inc. US Stem Cell, Inc. | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 8/9/2016 | |||||
| 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 | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Discussion with medical experts and risk management personnel regarding documentation of risks/benefits discussion with patients. | |||||||||||||||||||||
| 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.
| Department File Number : | M201990683 |
| Claim Number : | 165314 |
| Date Submitted : | 11/21/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-2301054 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Diane | M | McNab | ||
| Street Address | |||||
| 5555 Gate Parkway, Suite 150 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32256 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 439 - 0580 | dmcnab@norcal-group.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shareen | Greenbaum | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 11011 Sheridan Street, Suite 215 | ||||
| City | State | Zip Code | County | ||
| Cooper City | FL | 33026 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 724604E | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME97538 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| 45TH STREET MENTAL HEALTH CENTER | 104008 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | physician office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/11/2015 | 8/22/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient presented to this health care provider with a medical history of bilateral macular degeneration. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The patient consented in having stem cell eye injection treatments in her right eye to treat her macular degeneration. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis. The patient alleged the treatment was contraindicated and did not help her and thus caused decreased vision of the right eye. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| blindness in right eye | |||||
| Severity Of Injury | |||||
| Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 8/2/2018 | 17th Judicial | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 11/6/2019 | ||||
| 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 Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 11/18/2019 | |||||
| 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 | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Insured met and conferenced with defense attorney and claims representative | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201679786 |
| Claim Number : | 108317 |
| Date Submitted : | 9/27/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| OPHTHALMIC MUTUAL INSURANCE COMPANY (A R.R.G.) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-3047990 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | Medical Risk Consultant Group | ||||
| Street Address | |||||
| PO Box 431271 | |||||
| City | State | Zip | |||
| Miami | FL | 33243-1271 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 668 - 0432 | (305) 668 - 0433 | MMORENO@MRCG.ORG | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Shareen | Greenbaum | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 11011 Sheridan Street | ||||
| City | State | Zip Code | County | ||
| Hollywood | FL | 33026 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0012217 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME97538 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/15/2015 | 10/9/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Age-Related Macular Degeneration of the Retina | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient with AMD sought evaluation for confirmation of diagnosis prior to undergoing experimental treatment by another healthcare provider at another facility; NOT at the physicians office NOR by this physician. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis; the patient did have AMD. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Decreased vision | |||||
| Severity Of Injury | |||||
| Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 7/19/2016 | 2015-021463 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 8/25/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| US Stem Cell, Inc. Perez, Alejandro BioHeart, Inc. | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within 90 days of suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 8/2/2016 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $750,000 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Discussion with medical experts and risk management personnel regarding documentation of risk/benefit discussion with patients. | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
Does Dr. SHAREEN GREENBAUM, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SHAREEN GREENBAUM, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).