Department File Number : | M202091276 |
Claim Number : | 59088 |
Date Submitted : | 1/28/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mercedes | Pressley | |||
Street Address | |||||
3535 Piedmont Road NE | |||||
City | State | Zip | |||
Atlanta | GA | 30305 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 842 - 4882 | MPressley@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mohamed | F | Razak | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 2015 W. Lake Hamilton Dr. | ||||
City | State | Zip Code | County | ||
Winter Haven | FL | 33881 | Polk | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1601961 11 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME73093 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Polk | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HEART OF FLORIDA BEHAVIORAL CENTER | 104006 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/8/2014 | 9/1/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented with right upper quadrant abdominal pain and nausea. He denied chest pains, palpitation and shortness of breath. White blood cell counters were elevated at 16.3 thou/u and glucose elevated at 410 mg/dL. A right upper quadrant ultrasound showed pericholecystic fluid with gallbladder wall thickening. The patient was admitted to the hospital. He was given nothing by mouth, placed on insulin, intravenous antibiotics and fluids, and a surgical consult was obtained for treatment of Acalculous cholecystitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Not available | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to diagnose and treat pericarditis and cardiac effusion. | |||||
Principal Injury Giving Rise To The Claim | |||||
Death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/27/2017 | 2016-CA-000475-MP | ||||
County Suit Filed in | Date of Final Disposition | ||||
Osceola | 1/21/2020 | ||||
Other Defendants Involved in this Claim | |||||
Hussain, Sayed Smith, elliot Poinciana Medical Center, Inc. Florida Cardiology, PA Weatherby Locums, Inc. Heartland Healthcare, Inc. Haine City HMA, LLC | |||||
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 | |||||
1/21/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $99,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $57,536 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,759 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Risk Management has counseled insured. |
Updates | |
No updates found. |
Does Dr. MOHAMED F RAZAK, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MOHAMED F RAZAK, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).