Department File Number :	M200323689
Claim Number :	E28830-01
Date Submitted :	3/5/2003

Insurer Information
Insurer Name				Coverage Type
PRONATIONAL INSURANCE COMPANY				Primary
Insurer FEIN		Professional License Number
38-2317569
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	DAVID			MCKENNEY
Street Address
2801 S.W. 149th Avenue, Suite 200
City				State	Zip
Miramar				FL	33027
Phone	Ext	Fax	E-Mail Address
(954) 442 - 3113	5858	(954) 602 - 5852	dmckenney@proassurance.com

Insured Information
Type	First Name		MI	Last Name
Individual	MANUEL		B	CUESTA
Insurer Type		Street Address of Practice
Licensed		P.O. BOX 530336
City		State	Zip Code	County
MIAMI SHORES		FL	33153	Dade
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
0056800		$250,000		$750,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME0029548		Neurology - Including Child - No Surgery		0

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
			F	*NR
City			State	Zip Code
Location where injury occured		Other location where injury occured
Hospital Inpatient Facility
Name of Institution		Code
PARKWAY REGIONAL MEDICAL CENTER		100114
Location of Institutional Injury		Other Location of Institutional Injury
Critical Care Unit
Date of Occurrence		Date Reported to Insurer
1/18/1999		12/28/1999

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition

Liver disease and renal failure.

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

Consumption of Tasmar (Tolcapone( per doctor's orders.

Diagnostic Code :

Misdiagnosis Made, If Any, Of Patient's Actual Condition

N/A

Principal Injury Giving Rise To The Claim

Alleged failure to obtain timely liver function studies and failure to discharge patient from Tasmar medication per FDA recall.

Severity Of Injury

Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
9/25/2000	00-21286CA27
County Suit Filed in	Date of Final Disposition
Dade	1/20/2003
Other Defendants Involved in this Claim
VIC, INC. UNITED HEALTHCARE OF FLORIDA, INC. & UNITED HEALTHCARE SVS ARTILES, M.D., JUAN PAGLIERY, M.D., JOSE VEC, INC. LANDESS, M.D., CARRIE FLORIDA NEUROLOGY NETWORK, INC. MOMENI, D.O., TONY HOFFMAN-LAROCHE, 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

$250,000

Loss Adjust Expense Paid to Defense Counsel

$24,158

All Other Loss Adjustment Expense Paid

$13,506

Injured Person's Total Non-Economic Loss

$250,000

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

Insured discussed claim with insurance personnel and medical experts.

Updates

No updates found.