Department File Number : | M201679772 |
Claim Number : | 59235801 |
Date Submitted : | 9/27/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
13-4235490 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | D | King | ||
Street Address | |||||
901 south mopac Blvd V ste 400 | |||||
City | State | Zip | |||
Austin | TX | 78746 | |||
Phone | Ext | Fax | E-Mail Address | ||
(512) 425 - 5940 | (512) 328 - 8067 | john-king@tmlt.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dario | Grisales | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 16542 North Dale Mabry Highway | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33618 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
133280 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79046 | Anesthesiology - Pain Management |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MEMORIAL HOSPITAL - TAMPA | 100206 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/2/2015 | 7/16/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
50 year old male patient was admitted to hospital in January 1, 2015 with a recent history of ongoing severe back pain radiating to neck and lower body. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient was seen by numerous physicians prior to his presentation at the hospital in January 2015 for this condition. Our insured physician was consulted for a pain management consultation. Our insured physician saw the patient at the hospital and diagnosed the patient with thoracic spine spine and was prescribed pain medication. This was the first and only time our insured physician saw the patient. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Two days later, while still in the hospital the patient lost complete function of both legs. Additional imaging testing were completed which diagnosed an epidural thoracic abscess. | |||||
Principal Injury Giving Rise To The Claim | |||||
An epidural abscess had been compressing the spinal cord which likely caused patient's symptoms. During this time, the patient was seen by numerous physicians who were unable to diagnose the cause of his severe back pain. | |||||
Severity Of Injury | |||||
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/5/2015 | 15-CA-010159 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 9/15/2016 | ||||
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 | |||||
9/1/2015 |
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 | $73,096 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $9,654 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Safety management steps would include when seeing new patients in a hospital setting, make sure the previous medical records including imaging tests are accessed in the hospital's system to obtain the complete history picture of the patient. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201677806 |
Claim Number : | 59215002 |
Date Submitted : | 4/1/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
13-4235490 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Antrine | Long | |||
Street Address | |||||
361 Hillsboro Blvd. | |||||
City | State | Zip | |||
Deerfield Beach | FL | 33441 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 788 - 5184 | (954) 944 - 1382 | along@picinsurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DARIO | A | GRISALES | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 16542 N Dale Mabry Hwy | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33618 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
133280 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79046 | Anesthesiology - Pain Management |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
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 | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/24/2014 | 4/8/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient is a Type II Diabetic who presented to the insured for pain management of the lower extremities. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
A Pain Pump was implanted in the patient in 2008, but had to be replaced in 2014. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
AFTER THE INSURED REMOVED THE PAIN PUMP IN APRIL 2014,THE PATIENT DEVELOPED PROBLEMS IN THE PAIN PUMP POCKETWHICH PROMPTED THE REMOVAL IN JUNE 2014. BETWEEN APRILAND JUNE 2014, THE PATIENT HAD ONGOING ISSUES AND HAD TOBE HOSPITALIZED AND TREATED WITH ANTIBIOTICS DUE TOREDNESS AND DRAINAGE. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/7/2015 | 15-CA-008520 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 3/2/2016 | ||||
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 | |||||
3/14/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $48,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $20,374 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $7,491 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
None to report |
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. DARIO GRISALES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DARIO GRISALES, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).