Department File Number : | M201574256 |
Claim Number : | 2013-09-200-012 |
Date Submitted : | 4/10/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LEXINGTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-114949 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Amy | A | Villareal | ||
Street Address | |||||
16255 Bay Vista Drive | |||||
City | State | Zip | |||
Tampa | FL | 33760 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 519 - 1274 | amy.villareal@baycare.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Alexander | Paloma | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 2727 W. Dr. MLK Jr. Blvd | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33607 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
112-31-715 | $250,000 | $75,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME92255 | 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 | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/5/2011 | 7/16/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
30 week infant transferred to SJCH with multiple pre-term conditions, including interrupted aortic arch, which required surgery. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Surgical repair of aortic arch and other cardiac abnormalities. Post surgery arrhythmias and "codes" called. Patient stablized, PIV access removed by order. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
8 days later access could not be established. Patient expired. Dr. Paloma's only roll was intubation of the infant during the first code, which he accomplished on his first attempt. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/17/2014 | 13-CA-9263 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 3/25/2015 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
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 | $22,173 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Any risk issues have been/will be addressed. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ALEXANDER PALOMA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ALEXANDER PALOMA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).