Department File Number : | M201989185 |
Claim Number : | GC108-462a2015319322 |
Date Submitted : | 6/26/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CARE RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
52-2395338 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Sarah | McIntosh | |||
Street Address | |||||
PO Box 22989 | |||||
City | State | Zip | |||
Louisville | KY | 40252 | |||
Phone | Ext | Fax | E-Mail Address | ||
(502) 708 - 3103 | (502) 326 - 5909 | smcintosh@rmsc.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | AWILDA | PENA JIMENEZ | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 755 8th Ave. | ||||
City | State | Zip Code | County | ||
Hialeah | FL | 33010 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PPG0900029 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME107050 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Examination Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
3/23/2015 | 11/15/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
CBC revealed an elevated eosinophils. A flare up of ulcerative colitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
A 10-day course of prednisone was prescribed. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to timely diagnose and treat a strongyloides infection which resulted in death. By prescribing prednisone this masked the patient's symptoms. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/16/2017 | 16-019520CA32 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 4/30/2019 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
5/9/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $67,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $50,660 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $55,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Policy in place. |
Updates | |
No updates found. |
Does Dr. AWILDA PENA JIMENEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AWILDA PENA JIMENEZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).