PLCR

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M202298077
Claim Number : 41900000661
Date Submitted : 2/2/2022
 
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 Shandra K Parks
Street Address
TDC - Jacksonville, 12724 Gran Bay Pkwy W, Suite 400
City State Zip
Jacksonville FL 32258
Phone Ext Fax E-Mail Address
(517) 324 - 6857   (707) 927 - 1809 sparks@thedoctors.com
 
Insured Information
 
Type First Name MI Last Name
Individual Antonio L Ocana
Insurer Type Street Address of Practice
Licensed 6553 Gunn Highway
City State Zip Code County
Tampa FL 33625 Hillsborough
Policy Number Per Claim Policy Limits Aggregate Policy Limits
0936404 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME95608 Family Physicians or General Practitioners - No Surgery  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  M Hillsborough
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
Other physician's office
Date of Occurrence Date Reported to Insurer
1/24/2019 5/4/2021
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Back pain, cough
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Prescription medications, X-rays
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
There was no misdiagnosis
Principal Injury Giving Rise To The Claim
The patient alleges failure to diagnose and treat a lung infection, resulting in prolonged hospital admission.
Severity Of Injury
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Legal Information
 
Date of Suit Circuit Court Case Number
9/9/2021 21CA007283
County Suit Filed in Date of Final Disposition
Hillsborough 1/4/2022
Other Defendants Involved in this Claim
Ocana Medical Center, LLC
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
1/4/2022
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $237,500
Loss Adjust Expense Paid to Defense Counsel $17,418
All Other Loss Adjustment Expense Paid $16,690
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
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. Patient Safety referral is made if appropriate.
 
Updates
 
No updates found.

 

 

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