Department File Number : | M201574434 |
Claim Number : | 323093 |
Date Submitted : | 4/30/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tiffany | D | Taylor | ||
Street Address | |||||
13450 West Sunrise Blvd | |||||
City | State | Zip | |||
Sunrise | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | TTaylor@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Maria | C | Mas | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3181 Coral Way, 5th Floor | ||||
City | State | Zip Code | County | ||
Miami | FL | 33145 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0060668 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79887 | Internal Medicine - Minor 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 | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Emergency Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
11/4/2009 | 10/2/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the ER with chest pain nausea and vomiting. He subsequently died of an ascending aorta dissection. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured was consulted but the patient died before the insured saw him. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/13/2012 | 12-05499 CA 13 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 4/17/2015 | ||||
Other Defendants Involved in this Claim | |||||
Mercy Hospital, Inc. Fernandes, DO, Lianne Marshall,Amaya & Anton dba Emergency Room Medical Asso, LLC Rafael Jose Mas, M.D. Mas Medical Group, Inc. Mas Cardiology Group, Inc. Mark Hunter Kravetz, M.D. Ronald Charles Joseph, M.D. South Florida Medical Imaging, PA Parkway Medical Imaging, PA Coral Gables Medical Imaging, P.A. Hollywood Medical Imaging, PA Adebayo, Ismail Dania, M.D., Ademiniyi | |||||
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 | |||||
4/9/2015 |
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 | $13,815 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*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 : | M201884380 |
Claim Number : | 336381 |
Date Submitted : | 2/20/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
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 | Maria | C | Mas | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3181 Coral Way 5th Floor | ||||
City | State | Zip Code | County | ||
Miami | FL | 33145 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0060668 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79887 | Internal Medicine - 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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MERCY HOSPITAL, INC. | 100061 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/14/2015 | 11/25/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the hospital with gastric complaints including vomiting blood and coffee ground emesis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured evaluated the patient. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient died. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/8/2016 | 2016-014875-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 2/6/2018 | ||||
Other Defendants Involved in this Claim | |||||
Mas Medical Group, Inc. | |||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Dismissed | ||||
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 | $36,652 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $28,788 | ||||||||||||||||||||
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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. MARIA C MAS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARIA C MAS, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).