M19991215

Insurer Information

Insurer Name				Coverage Type
FRONTIER INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
13-2559805
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	CAROL			LOBACZ
Street Address
6360 NW 5TH WAY, SUITE 303
City				State	Zip
FT. LAUDERDALE				FL	33309
Phone	Ext	Fax	E-Mail Address
(954) 491 - 6078	111	(954) 491 - 6610

Insured Information

Type	Entity Name
Entity	CIRCLES OF CARE / SUBRAMANIYAM M . VASUDEVAN, M.D.
Insurer Type	Street Address of Practice
Licensed	400 EAST SHERIDAN RD.
City	State	Zip Code	County
MELBOURNE	FL	32901	Brevard
Policy Number	Per Claim Policy Limits		Aggregate Policy Limits
FPL000265	$1,000,000		$3,000,000
Profession or Business		Other Profession or Business
Medical Doctor
License Number	Specialty Code & Classification		Certification Number
35666	Physciatry - Including Child		80249

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	*NR
City			State	Zip Code

Location where injury occured		Other location where injury occured
Prison		CIRCLES OF CARE
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
11/2/1995		6/5/1997

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
ANXIETY
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
THE PLAINTIFF WAS ADMITTED TO CIRCLES OF CARE ON A FORM 52 FROM WUESTHOFF HOSPITAL , WHERE HE HAD BEEN EVALUATED FOR GASTRIC CRAMPS. THE FOLLOWING DAY HE WAS EVALUATED AND IT WAS DETERMINED THAT HE DID NOT NEED ANY PSYCHIATRIC TREATMENT. TWO DAYS LATER HE WAS ADMITTED TO THE HOSPITAL AND UNDERWENT AN END COLOSTOMY FOR A NECROTIC PERFORATED SIGMOID DIVERTICULUM. THE PLAINTIFF ATTORNEY ALLEGED A FAILURE TO DISCHARGE THE PATIENT TO A MEDICAL CENTER FOR IMMEADIATE TREATMENT.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
N/A
Principal Injury Giving Rise To The Claim
PERFORATION OF THE SIGMOID DIVERTICULUM
Severity Of Injury
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed.

Legal Information

Date of Suit	Circuit Court Case Number
10/21/1997	97-17839-CA -X
County Suit Filed in	Date of Final Disposition
Brevard	10/26/1999
Other Defendants Involved in this Claim
EMCARE , INC WUESTHOFF MEMORIAL HOSPITAL, INC
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

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$200,000

Loss Adjust Expense Paid to Defense Counsel

$48,470

All Other Loss Adjustment Expense Paid

$12,428

Injured Person's Total Non-Economic Loss

$200,000

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

THE INSURED DISCUSSED CASE WITH DEFENSE COUNSEL AND INSURANCE PERSONNEL

Updates

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