| Department File Number : | M201885795 |
| Claim Number : | 186597 |
| Date Submitted : | 9/26/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PROASSURANCE SPECIALTY INSURANCE COMPANY, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-3990058 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Denise | Stokes | |||
| Street Address | |||||
| 100 Brookwood Place | |||||
| City | State | Zip | |||
| Birmingham | AL | 35209 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Alejandro | T | Soler | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3140 NW Medical Center Lane, Suite 120 | ||||
| City | State | Zip Code | County | ||
| Lake City | FL | 32055 | Columbia | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| ES1561 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME91799 | Physicians - Minor Surgery. NOC classification. | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Columbia | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| LAKE CITY MEDICAL CENTER | 100156 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 12/6/2012 | 5/8/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Esophageal reflux | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Nissan Fundoplication | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged improper surgical procedure resulting in extended hospital stay. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/5/2014 | 122014CA | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Columbia | 6/22/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Notami Hospitals of Florida, Inc. Gateway surgical Specialists LLC Lake City Medical Center Gateway surgical Group, LLC | |||||
| 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 | |||||
| 7/2/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $75,354 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $35,171 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $225,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Insured discussed case with defense counsel, insurance personnel, and medical experts. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 7/3/2018 3:45:21 PM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
| ||||||||||
| Date of Change: | 7/31/2018 11:11:41 AM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
| ||||||||||
| Date of Change: | 8/3/2018 2:50:26 PM | |||||||||
| Reason for Change: | updated alae | |||||||||
| ||||||||||
| Date of Change: | 9/26/2018 1:00:27 PM | |||||||||
| Reason for Change: | updated alae | |||||||||
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| Department File Number : | M201782112 |
| Claim Number : | 186598 |
| Date Submitted : | 7/28/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PROASSURANCE SPECIALTY INSURANCE COMPANY, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-3990058 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Denise | Stokes | |||
| Street Address | |||||
| 100 Brookwood Place | |||||
| City | State | Zip | |||
| Birmingham | AL | 35209 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Alejandro | T | Soler | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3140 NW Medical Center Lane, Suite 120 | ||||
| City | State | Zip Code | County | ||
| Lake City | FL | 32055 | Columbia | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| ES1561 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME91799 | Surgery - General Practice or Family Practice | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Columbia | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| LAKE CITY MEDICAL CENTER | 100156 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/27/2011 | 5/8/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Hiatal hernia, severe GERD, cholelithiasis | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Nissan fundoplication, hiatal hernia repair with mesh, and laparoscopic cholecystectomy | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Respiratory insufficiency and ileus post op requiring extended hospital stay | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/5/2014 | 14-97-CA | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Columbia | 5/9/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Lake City Medical Center Gateway Surgical Group LLC | |||||
| 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 | |||||
| Disposed of by Arbitration | |||||
| Court Decision | Other | ||||
| Summary 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? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $35,843 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $6,887 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Insured discussed case with defense counsel, insurance personnel, and medical experts. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 7/28/2017 9:53:16 AM | |||||||||
| Reason for Change: | updated ALAE information | |||||||||
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Does Dr. ALEJANDRO T SOLER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ALEJANDRO T SOLER, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).