Department File Number : | M201573956 |
Claim Number : | G10016710 |
Date Submitted : | 3/26/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
GENERAL STAR INDEMNITY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
06-0876629 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Letitia | Boice | |||
Street Address | |||||
120 Long Ridge Road | |||||
City | State | Zip | |||
Stamford | CT | 06902 | |||
Phone | Ext | Fax | E-Mail Address | ||
(203) 328 - 5646 | (203) 328 - 6444 | Letitia.Boice@gumc.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Juan | M | Raposo | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4308 Alton Road | ||||
City | State | Zip Code | County | ||
Miami | FL | 33140 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
IJG409981 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME104124 | Surgery - Orthopedic |
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 | ||||
MOUNT SINAI MEDICAL CENTER | 100034 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/15/2010 | 2/16/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Back pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent an L4-5 and L5-S1 transforaminal decompression with interbody fusion through a right-sided approach with bilateral pedicle screw fixation at L4, L5, and S1 | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
complications from surgery- alleged doctor was negligent in performing a spinal decompression and fusion | |||||
Principal Injury Giving Rise To The Claim | |||||
Cauda Equine Syndrome | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/8/2011 | 1117671CA20 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 1/12/2014 | ||||
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 | |||||
12/24/2013 |
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 | $406,559 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $100,843 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $10,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
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Department File Number : | M201574763 |
Claim Number : | 1012406-01 |
Date Submitted : | 8/25/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Susan | K | Spielman | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0340 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JUAN | M | RAPOSO | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3650 NW 82nd Ave, Ste 201 | ||||
City | State | Zip Code | County | ||
Doral | FL | 33166 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
763941 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME104124 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Miami Neck and Back Institute | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/11/2012 | 9/25/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Chronic leg and back pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Spinal cord stimulator placement | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to remove spinal cord stimulator upon noting neurological deficits | |||||
Principal Injury Giving Rise To The Claim | |||||
Permanent neurological deficits including spinal cord 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 | ||||
3/4/2015 | 15-002081 CA 01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 5/15/2015 | ||||
Other Defendants Involved in this Claim | |||||
Miami Neck and Back 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 | |||||
5/14/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $165,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $14,554 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,310 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $128,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
Updates | ||||||||||
Date of Change: | 8/25/2015 4:29:16 PM | |||||||||
Reason for Change: | ALE UPDATE | |||||||||
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Does Dr. JUAN M RAPOSO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JUAN M RAPOSO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).