Department File Number : | M201575517 |
Claim Number : | FP4429202/01 |
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 | Margoth | Diaz | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 900 South Pine Island Road, Suite 800 | ||||
City | State | Zip Code | County | ||
Plantation | FL | 33324 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
CL099521 | $1,000,000 | $1,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME78579 | 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 De La Rua, Mairim | |||||
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 | $115,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
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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. |
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Does Dr. MARGOTH DIAZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARGOTH DIAZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).