Department File Number : | M201989005 |
Claim Number : | GC108-462a2015319322 |
Date Submitted : | 6/7/2019 |
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) 705 - 3103 | (502) 326 - 5909 | smcintosh@rmsc.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Edmundo | Tamayo | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 9037 Biscayne Blvd. | ||||
City | State | Zip Code | County | ||
Miami Shores | FL | 33138 | 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 | |||
ME67715 | 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 | ||||
Other Hospital/Institution | Tamayo Urgent Care, Inc. | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Examination Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
5/26/2015 | 11/15/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
This physician was the primary care physician of the patient for several years. The patient's medical history included chronic ulcerative colitis and ulcers in the digestive tract. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Lab studies were ordered. The patient was taking cipro and metronidazole. | |||||
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. | |||||
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 | |||||
Pena-Jimenez, Awilda | |||||
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 | |||||
5/7/2019 |
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 | $50,000 | ||||||||||||||||||||
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. |
Department File Number : | M202093100 |
Claim Number : | GC100-108-462a201633 |
Date Submitted : | 7/29/2020 |
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 | David | Prisco | |||
Street Address | |||||
285 Cozzins Street | |||||
City | State | Zip | |||
Columbus | OH | 43215 | |||
Phone | Ext | Fax | E-Mail Address | ||
(614) 220 - 9228 | david.prisco@assuredpartners.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Edmundo | Tamayo | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 9037 Biscayne Blvd | ||||
City | State | Zip Code | County | ||
Miami | FL | 33136 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PPL0900434 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67715 | 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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MERCY HOSPITAL, INC. | 100061 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/4/2016 | 11/7/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Low back pain radiating to left lower extremity. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Referral for neurosurgical consultation pursuant to Humana requirements and cleared the patient for decompression discectomy. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged inappropriate referral to a neurosurgeon and cleared patient for surgery. | |||||
Principal Injury Giving Rise To The Claim | |||||
Spinal nerve root damage. | |||||
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 | ||||
11/24/2019 | 2019-026224 CA | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 6/26/2020 | ||||
Other Defendants Involved in this Claim | |||||
Widi, Gabriel Mercy Hospital Advanced Neuro Spine Institute | |||||
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 | |||||
6/30/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $20,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $14,474 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,099 | ||||||||||||||||||||
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 | |||||||||||||||||||||
A business decision settlement with no admission of liability or wrongdoing as the co-defendants are the targets and litigation costs would be expensive. |
Updates | |
No updates found. |
Does Dr. EDMUNDO TAMAYO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. EDMUNDO TAMAYO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).