Department File Number : | M201573932 |
Claim Number : | 152555 |
Date Submitted : | 3/24/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | O | Agbi | ||
Street Address | |||||
2542 cooper way | |||||
City | State | Zip | |||
wellington | FL | 33414 | |||
Phone | Ext | Fax | E-Mail Address | ||
(718) 541 - 9611 | andrewomoh@hotmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | Agbi | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2542 cooper way | ||||
City | State | Zip Code | County | ||
wellington | FL | 33414 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
152555 | $1,000,000 | *NR | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10970 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | home | ||||
Name of Institution | Code | ||||
PLANTATION GENERAL HOSPITAL | 100167 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | EMS | ||||
Date of Occurrence | Date Reported to Insurer | ||||
5/6/2013 | 1/14/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
55 yof Patient with hx of diabetes, anemia, hypertension presented to the ER for abdominal pain, nausea, vomiting and diarhhea after a wedding ceremony. everyone that went with her had similar complaints. Family members claimed possible food poisioning. CBC, CMP, PT/PTT, EKG, Chest X-ray done and was interpreted by me as within reasonable normal limit for the patient. Pt tolerated both IV fluids and oral fluids. was well appearing and stable upon discharge . | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Pt went home and two days later continued to complained about abdominal pain . EMS was called . Upon EMS arrival, pt went into cardiopulmonary arrest and died later that day. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO misdiagnosis on patients condition on the day of initial presentation to the er. | |||||
Principal Injury Giving Rise To The Claim | |||||
1. Alleged failure/delay to admit to the hospital2. Alleged failure to Diagnose ?? | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 1/14/2015 | ||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/14/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Will admit all pt with nausea, vomiting, diarrhea and abdominal pain |
Updates | |||||||
Date of Change: | 3/24/2015 12:02:38 AM | ||||||
Reason for Change: | amount on policy was wrong | ||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201574336 |
Claim Number : | 152555 |
Date Submitted : | 4/17/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | Agbi | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1613 N Harrison Parkway | ||||
City | State | Zip Code | County | ||
Sunrise | FL | 33323 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10113 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10970 | Emergency Medicine - No Major Surgery | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
PLANTATION GENERAL HOSPITAL | 100167 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Emergency Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
5/6/2013 | 6/20/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Uncontrolled diabetes, upper gastrointestinal bleed, severe anemia, hypertension. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient treated in ER for abdominal pain, nausea, vomiting & diarrhea. Hemoglobin was low & hematocrit was also low. & PTT was elevated. Sodium was low & BUN & creatinine were elevated. Chest x-ray showed cardiomegaly. No abdominal radiology studies ordered. Patient discharged home. Allege patient should have been admitted for further work up in light of low hemoglobin & hematocrit & elevated PTT. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death, sepsis. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 4/7/2015 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
2/6/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,205 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,915 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $125,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of policies and procedures. |
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.
Department File Number : | M201885824 |
Claim Number : | 153746 |
Date Submitted : | 7/6/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christina | J | Stoker | ||
Street Address | |||||
1100 Charlotte Ave, Ste 500 | |||||
City | State | Zip | |||
Nashville | TN | 37203 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 1779 | (615) 344 - 5889 | christina.stoker@hcahealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ANDREW | O | AGBI | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1613 N HARRISON PARKWAY | ||||
City | State | Zip Code | County | ||
SUNRISE | FL | 33323 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10114 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10970 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
PLANTATION GENERAL HOSPITAL | 100167 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | EMERGENCY ROOM | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/9/2014 | 11/10/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PRESENTED WITH COMPLAINTS OF CHEST PAIN AND SHORTNESS OF BREATH. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EXAMINED AND PLACED ON BIPAP. CT OF CHEST PERFORMED WITH PATIENT ON A NON-REBREATHER MASK. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
DURING CT SCAN, PATIENT DETERIORATED AND CODED. PATIENT DEATH. ALLEGED DELAY IN INTUBATION. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 6/22/2018 | ||||
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 | $139,150 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $17,744 | ||||||||||||||||||||
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 | |||||||||||||||||||||
REVIEW OF POLICIES AND PROCEDURES. |
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. ANDREW AGBI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANDREW AGBI, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).