Department File Number : | M201783736 |
Claim Number : | 218494 |
Date Submitted : | 7/10/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE INDEMNITY COMPANY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
63-0720042 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | Stokes | |||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ghulam | Jafferi | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6731 SW 63rd Avenue | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP102758 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME72934 | 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 | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/20/2015 | 2/22/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Vomiting, diarrhea, fever, chills, syncope | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Emergency Department evaluation and treatment | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
69 YOM expired allegedly due to failure to timely and appropriately manage 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 | 10/23/2017 | ||||
Other Defendants Involved in this Claim | |||||
Tenet Hialeah Heatlth System, Inc. Hialeah Hospital, Inc Paragon contracting Services LLC | |||||
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 | |||||
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 | $8,572 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,848 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
Updates | ||||||||||
Date of Change: | 12/1/2017 1:03:35 PM | |||||||||
Reason for Change: | Updated ALAE information | |||||||||
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Date of Change: | 1/5/2018 4:03:02 PM | |||||||||
Reason for Change: | Updated ALAE information | |||||||||
| ||||||||||
Date of Change: | 5/23/2018 2:33:56 PM | |||||||||
Reason for Change: | updated alae | |||||||||
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Date of Change: | 7/10/2018 1:33:07 PM | |||||||||
Reason for Change: | updated alae | |||||||||
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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 : | M201988650 |
Claim Number : | 221596 |
Date Submitted : | 9/26/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE INDEMNITY COMPANY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
63-0720042 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | Stokes | |||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | GHULAM | JAFFERI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6731 SW 63 Avenue | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP102758 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME72934 | Emergency Medicine - No Major 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 | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
HIALEAH HOSPITAL | 100053 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/21/2015 | 7/13/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Angioedema | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No description of the operation, diagnostic or treatment procedure rendering cause of the injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No description of any misdiagnosis made of the patients actual condition | |||||
Principal Injury Giving Rise To The Claim | |||||
Death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/12/2018 | 2017-028157-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 7/3/2019 | ||||
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 | |||||
5/6/2019 |
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 | $18,094 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $15,884 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
Updates | |
No updates found. |
Department File Number : | M201573700 |
Claim Number : | MM265362 |
Date Submitted : | 3/9/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EVANSTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2950161 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kimberly | C | Stokes | ||
Street Address | |||||
4600 Cox Road | |||||
City | State | Zip | |||
Glen Allen | VA | 23831 | |||
Phone | Ext | Fax | E-Mail Address | ||
(804) 287 - 6965 | kimberly.stokes@markelcorp.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | GHULAM | A | JAFFERI | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 651 E. 25th St. | ||||
City | State | Zip Code | County | ||
Hialeah | FL | 33013 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MM822776 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME72934 | Emergency Medicine - Including Major 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 | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
HIALEAH HOSPITAL | 100053 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/3/2013 | 1/3/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient suffered a ruptured admominal aortic aneurysm. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
It is alleged that an abdominal CT was not ordered until 3 1/2 hours post admission despite almost certain signs of a ruptured admonimal aortic aneurysm. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient passed away. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/7/2014 | 14-008458CA01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 8/14/2014 | ||||
Other Defendants Involved in this Claim | |||||
Paragon Contracting Services, Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
7/1/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $3,500 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $5,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
none |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Does Dr. GHULAM JAFFERI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GHULAM JAFFERI, MD has at least 4 medical malpractice case(s), lawsuit(s), or complaint(s).