| Department File Number : | M201783859 |
| Claim Number : | 211753 |
| Date Submitted : | 10/29/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PROASSURANCE CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 38-2317569 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Denise | Stokes | |||
| Street Address | |||||
| 100 Brookwood Place | |||||
| City | State | Zip | |||
| Birmingham | AL | 35209 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | MARVIN | DIAZ-LACAYO | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 19721 NE 22nd | ||||
| City | State | Zip Code | County | ||
| Aventura | FL | 33180 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MP54951 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME22072 | Hematology - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/2/2015 | 4/19/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| colon adenocarcinoma | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| chemotherapy | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Pathology diagnosed colon adenocarcinoma as Stage II but there were 5 out of 13 positive nodes. Insured treated as Stage III because of the node involvement utilizing chemotherapy. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| during treatment, patient had infiltration of chemotherapy medication when port malfunctioned which resulted in necrosis. | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 8/7/2017 | 17-015014(18) | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 12/11/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Pactor, Caroline R | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within 90 days of suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 12/13/2017 | |||||
| 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 | $26,348 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $19,908 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Insured discussed case with defense counsel, insured personnel, and medical experts. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 12/27/2017 11:20:40 AM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
| ||||||||||
| Date of Change: | 3/29/2018 12:43:18 PM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
| ||||||||||
| Date of Change: | 10/29/2018 2:16:45 PM | |||||||||
| Reason for Change: | updated alae | |||||||||
| ||||||||||
This page is not displaying certain sensitive information.
Does Dr. MARVIN DIAZ-LACAYO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARVIN DIAZ-LACAYO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).