Department File Number : | M201574881 |
Claim Number : | FP4214904 |
Date Submitted : | 6/9/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ABD ALRAHMAN | BENNI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 132 South Moon Avenue | ||||
City | State | Zip Code | County | ||
Brandon | FL | 33511 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-89271 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME102050 | Anesthesiology - Pain Management |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
TAMPA GENERAL HOSPITAL | 100128 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/2/2009 | 9/6/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was transferred to Tampa General Hospital with a diagnosis of a fracture of the left ramus of the mandible. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Open reduction and internal fixation of the mandible fracture and maxiollomandibular fixation. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged delay in the evaulation and treatment of post operative breathing difficulty and pulmonary edem. | |||||
Principal Injury Giving Rise To The Claim | |||||
Death of 19 year old single female with 20 month old son. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/27/2012 | 12-00849 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 6/1/2015 | ||||
Other Defendants Involved in this Claim | |||||
Shah, Vimal Doyle, John Quatman, William Tampa General Hospital Moya, Jacinto | |||||
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 | |||||
No Payment Made | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $18,373 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,943 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
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Does Dr. ABD ALRAHMAN BENNI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ABD ALRAHMAN BENNI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).