M200324105

Insurer Information

Insurer Name				Coverage Type
AMERICAN PHYSICIANS ASSURANCE CORPORATION				Primary
Insurer FEIN		Professional License Number
38-2102867
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	MICHAEL		D	TUNGATE
Street Address
1301 N. HAGADORN ROAD PO BOX 1471
City				State	Zip
EAST LANSING				MI	48826-1471
Phone	Ext	Fax	E-Mail Address
(800) 748 - 0465		(517) 351 - 3720	MTUNGATE@ACAPONLINE.COM

Insured Information

Type	First Name		MI	Last Name
Individual	GAYLE			KESSELMAN, MD
Insurer Type		Street Address of Practice
Licensed		1342 COLONIAL BLVD STE K116
City		State	Zip Code	County
FORT MYERS		FL	33907-1012	Lee
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
127390		$1,000,000		$3,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME0046979		Physical Medicine and Rehabilitation		80235

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
Patient's Home
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
1/6/2001		4/18/2001

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
OVERDOSE
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
IT IS ALLEGED THAT INSURED FAILED TO TREAT PATIENT, A 44 YEAR OLD FEMALE FOR TYLENOL OVERDOSE RESULTING IN HER DEATH
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
N/A
Principal Injury Giving Rise To The Claim
DEATH
Severity Of Injury
Permanent: Death.

Legal Information

Date of Suit	Circuit Court Case Number
8/24/2001	018074CA
County Suit Filed in	Date of Final Disposition
Lee	2/3/2003
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

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$380,000

Loss Adjust Expense Paid to Defense Counsel

All Other Loss Adjustment Expense Paid

Injured Person's Total Non-Economic Loss

$380,000

Deductible

Injured Person's Total Economic Loss

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

INSURED CONSULTED WITH DEFENSE COUNSEL AND CLAIMS PERSONNEL REGARDING THIS MATTER.

Updates

No updates found.