Department File Number : | M201886577 |
Claim Number : | 2016011060 |
Date Submitted : | 9/28/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ALLIED WORLD SURPLUS LINES INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
51-0331163 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Michelle | Bedard | |||
Street Address | |||||
1690 New Britain Avenue, Suite 101 | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 284 - 1942 | (860) 284 - 1943 | Michelle.Bedard@awac.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Miguel | D | Attias | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3488 East Lake Road | ||||
City | State | Zip Code | County | ||
Palm Harbor | FL | 34685 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0303-2472 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME105839 | Anesthesiology - Pain Management |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Ambulatory surgery center | ||||
Name of Institution | Code | ||||
WESTCHASE SURGERY CENTER | 14960706 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Special Procedure Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/13/2015 | 4/14/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Back pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Intrathecal administration of pain medicine | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death secondary to alleged failure to convert an oral medication dose to an intrathecal administration dose. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/18/2016 | 16-CA-009666 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 9/21/2018 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
9/27/2018 |
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 | $32,471 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Worked closely with counsel to resolve claim. |
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.
Department File Number : | M201988931 |
Claim Number : | 2018017249 |
Date Submitted : | 5/30/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ALLIED WORLD SURPLUS LINES INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
51-0331163 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Joyce | M | Palmisano | ||
Street Address | |||||
1690 New Britain Ave. Suite 101 | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 284 - 1382 | 1382 | (860) 284 - 1383 | Joyce.Palmisano@awac.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Miguel | D | Attias | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3488 E. Lake Road Suite 403 | ||||
City | State | Zip Code | County | ||
Palm Harbor | FL | 34685 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0303-2472 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME105839 | Anesthesiology - Pain Management |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Tampa Pain Relief Center | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/11/2016 | 4/11/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Lower Back Pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Spinal Cord Stimulator Explant | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged surgical or other foreign body retained | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged foreign object in lower back after spinal cord stimulator explant. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 11/6/2018 | ||||
Other Defendants Involved in this Claim | |||||
Westchase Surgery Center Surgery Center Holdings, Inc. Surgery Partners, Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/9/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $55,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $3,611 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $55,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Worked closely with defense counsel to resolve claim. Allied World initially paid $55,000. for the settlement. This amount was later recovered from the Insured under their Deductible Indemnity Amount under the Policy. Settlement was $55,000. paid for Dr. Attias. |
Updates | |
No updates found. |
Does Dr. MIGUEL D ATTIAS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MIGUEL D ATTIAS, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).