Department File Number :

Insurer Information

Insurer Name				Coverage Type
SOUTH FLORIDA OPHTHALMOLOGICAL SELF INSURING TRUST				Primary
Insurer FEIN		Professional License Number
59-6628916
Insurer Contact Information
Type		Entity Name
Entity		SOUTH FLORIDA OPHTHALMOLOGICAL SELF INSURING TRUST
Street Address
C/O Medical Service Agents, Inc. 19 West Flagler St. #711
City				State	Zip
Miami				FL	33130
Phone	Ext	Fax	E-Mail Address
(305) 374 - 6368		(305) 371 - 4759	jas@Redluspa.com

Insured Information

Type	First Name		MI	Last Name
Individual	MARVIN		E	GREENBERG
Insurer Type		Street Address of Practice
Licensed		7421 N UNIVERSITY DR
City		State	Zip Code	County
TAMARAC		FL	33321-2977	Broward
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
210		$500,000		$1,500,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME 0036221		Surgery - Opthalmology		80114

Injured Person Information

First Name	MI	Last Name		Date of Birth

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

Location where injury occured		Other location where injury occured
Other Outpatient Facility
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
10/30/1996		10/30/1996

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Left eye cataract
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
cataract extraction
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
none
Principal Injury Giving Rise To The Claim
During the procedure, the syringe which was prepred by the scrub tecnician, became dislodged from the cannula and caused the implant to fall back into the vitreous. The condition was recognized immediately and another implant was placed. Patient did not suffer any consequences.
Severity Of Injury
Emotional Only - Fright, no physical damage

Legal Information

Date of Suit	Circuit Court Case Number
10/17/1997	97-016126
County Suit Filed in	Date of Final Disposition
Broward	10/26/2001
Other Defendants Involved in this Claim
FOUNDATION FOR ADVANCED EYE CARE
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
Disposed of by Court
Court Decision	Other
Judgment for the defendant.
Arbitration
Claim not subject to Arbitration.
Date of Payment

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Indemnity Paid by Insurer on behalf of Insured

Loss Adjust Expense Paid to Defense Counsel

$34,581

All Other Loss Adjustment Expense Paid

$11,800

Injured Person's Total Non-Economic Loss

Deductible

Injured Person's Total Economic Loss

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

None necessary. This matter went to trial and insured was found not to be negligent in the care rendered to patient.

Updates

No updates found.