Department File Number : | M201575518 |
Claim Number : | FP4429202 |
Date Submitted : | 8/12/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MAIRIM | DE LA RUA | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 900 South Pine Island Road, Suite 800 | ||||
City | State | Zip Code | County | ||
Plantation | FL | 33324 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
CL099521 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME106724 | Pediatrics - No Surgery |
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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Pediatric Associates, PA | ||||
Date of Occurrence | Date Reported to Insurer | ||||
9/14/2011 | 5/10/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought treament for chronic low back pain. The final diagnosis was myxopapillary ependyoma. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No treament or procedure caused injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to timely order MRI of the spine resulting in delayed diagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
Myxopapillary ependymoma and reduced life expectancy. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/1/2014 | 14-012376CA01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 7/14/2015 | ||||
Other Defendants Involved in this Claim | |||||
Pediatric Associates Ramos-Arias, Yadira Perello, Robert Sheridan Emergency Physicians Rivas-Chacon, Rafael Miami Childrens Hospital Baitner, Avi Romano-Silva, Amada | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $189,750 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $24,739 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $16,706 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201575519 |
Claim Number : | FP4429202/02 |
Date Submitted : | 8/12/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mairim | D | DE LA Rua | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 900 South Pine Island Road, Suite 800 | ||||
City | State | Zip Code | County | ||
Plantation | FL | 33324 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
CL099521 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME106724 | Pediatrics - Minor Surgery |
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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Pediatric Associates, PA | ||||
Date of Occurrence | Date Reported to Insurer | ||||
9/14/2011 | 5/10/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient sought treament for chronic low back pain. The final diagnosis was myxopapillary ependyoma. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No treament or procedure caused injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to timely order MRI of the spine resulting in delayed diagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
Myxopapillary ependymoma and reduced life expectancy. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/1/2014 | 14-012376CA01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 7/14/2015 | ||||
Other Defendants Involved in this Claim | |||||
Pediatric Associates Ramos-Arias, Yadira Perello, Robert Sheridan Emergency Physicians Rivas-Chacon, Rafael Miami Childrens Hospital Baitner, Avi Romano-Silva, Amada | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $189,750 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $24,739 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $16,706 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. MAIRIM DE LA RUA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MAIRIM DE LA RUA, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).