Department File Number :	M200430996
Claim Number :	4043921
Date Submitted :	5/13/2004

Insurer Information
Insurer Name				Coverage Type
SOUTH PINELLAS MEDICAL TRUST				Primary
Insurer FEIN		Professional License Number
59-6599936
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	TROY		J	CROTTS, ESQUIRE
Street Address
P. O. Box 210
City				State	Zip
St. Petersburg				FL	33731
Phone	Ext	Fax	E-Mail Address
(727) 896 - 0601		(813) 821 - 1968

Insured Information
Type	First Name		MI	Last Name
Individual	ERASMO		R	PASSARO, M.D.
Insurer Type		Street Address of Practice
Licensed		601 - 7TH STREET SOUTH
City		State	Zip Code	County
ST. PETERSBURG		FL	33701	Pinellas
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
47097-03		$1,000,000		$2,000,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
0067462		Neurology - Including Child - No Surgery		0000000000

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
BAYFRONT MEDICAL CENTER		100032
Location of Institutional Injury		Other Location of Institutional Injury
Patients' Room
Date of Occurrence		Date Reported to Insurer
6/1/2003		9/26/2003

Diagnostic Information

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

Third ventricle Cystercicosis.

Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury

The third ventricle Cystercicosis caused an acute obstruction, which likely lead to herniation and death.

Diagnostic Code :

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

None, based on available information at time of treatment.

Principal Injury Giving Rise To The Claim

The third ventricle Cystercicosis caused an acute obstruction, which likely lead to herniation and death.

Severity Of Injury

Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

Legal Information
Date of Suit	Circuit Court Case Number
	*NR
County Suit Filed in	Date of Final Disposition
*NR	5/6/2004
Other Defendants Involved in this Claim
SHAMAS, MD, JULIE STENGEL, MD, THOMAS BAYFRONT MEDICAL CENTER BAYFRONT FAMILY HEALTH CENTER WINTER HAVEN HOSPITAL QUICK, MD, ELIZABETH MANATEE FAMILY PHYSICIANS WEILAND, MD, DAVID THOMAS STENGEL MD PA DEEB, MD, ADRIENNE LABRADOR, MD, CARLOS GILLETT, MD, EDWARD R
Stage of Legal System at which Settlement was Reached or Award Made
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed).
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

$1,000,000

Loss Adjust Expense Paid to Defense Counsel

$3,776

All Other Loss Adjustment Expense Paid

$1,201

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

After reviewing and considering this matter at length, no specific steps were deemed to be necessary. However, Dr. Passaro will continue to be aware of the importance of timely neurosurgical consultation in the appropriate circumstance.

Updates

No updates found.