Department File Number : | M201886340 |
Claim Number : | SAM-IG-006615 |
Date Submitted : | 9/6/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3433505 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | NANCY | CARR | |||
Street Address | |||||
11440 SW 88th STREET | |||||
City | State | Zip | |||
MIAMI | FL | 33176 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Keslie | Gutierrez | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 8900 North Kendall Drive | ||||
City | State | Zip Code | County | ||
Miami | FL | 33176 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SPL 1062 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME108349 | 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 | ||||
BAPTIST HOSPITAL | 100093 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/28/2013 | 4/15/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Uncontrolled atrial fibrillation, upper respiratory infection and possible acute Non-ST elevation and myocardial infarction. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
There was no operation, diagnostic or treatment procedure that caused injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis of the patient's condition. | |||||
Principal Injury Giving Rise To The Claim | |||||
Development of a retroperitoneal hemorrhage, hypovolemia and stroke. The plaintiff's attorney alleged a failure to respond to critically ill lab values in a patient taking heparin, Coumadin and Plavix. Failure to call in appropriate consultations, failure to diagnose a retroperitoneal hemorrhage, failure to timely diagnose hypovolemia, and failure to timely intervene in a patient with a clinical presentation of internal hemorrhage and hypovolemia. These allegations were unsubstantiated and the suit was voluntarily dismissed. | |||||
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 | ||||
12/23/2015 | 2015-029853-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 4/9/2018 | ||||
Other Defendants Involved in this Claim | |||||
Baptist Hospital | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $41,065 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $9,503 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Physician discussed case with defense counsel and claim consultant. |
Updates | |
No updates found. |
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Does Dr. KESLIE GUTIERREZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KESLIE GUTIERREZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).