Department File Number : | M201573326 |
Claim Number : | FP3953703 |
Date Submitted : | 1/28/2015 |
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 | Dana | Mehra | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 350 North Pine Island Road, Suite 302 | ||||
City | State | Zip Code | County | ||
Plantation | FL | 33326 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-IN101743 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Registered Nurse | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ARNP9187956 | Family Physicians or General Practitioners - No 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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physician's Exam Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/11/2009 | 1/19/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right sided facial numbness. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Office visit, physical exam. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleges missed diagnosis of slow growing facial nerve tumor. By the time this patient presented to PCP, her prognosis was set and would not have changed with earlier diagnosis. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/4/2012 | 11-21134 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 1/27/2015 | ||||
Other Defendants Involved in this Claim | |||||
Goldin, Sylvan Frydman, Jarrod Vales-Preval, Marie | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $25,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $3,927 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,557 | ||||||||||||||||||||
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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. DANA MEHRA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DANA MEHRA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).