Department File Number : | M202092507 |
Claim Number : | 379208 |
Date Submitted : | 5/19/2020 |
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 | Shandra | K | Parks | ||
Street Address | |||||
TDC - Jacksonville, 12724 Gran Bay Pkwy W, Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(517) 324 - 6857 | (707) 927 - 1809 | sparks@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Niharika | Samtani | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1033 Martin Luther King Jr. St. N | ||||
City | State | Zip Code | County | ||
Saint Petersburg | FL | 33701 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0919828 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME132650 | Pediatrics - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
TAMPA GENERAL HOSPITAL | 100128 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/20/2018 | 1/3/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Severe sepsis, hypotension, acidosis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Pediatric Intensive Care management | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Multiple amputations related to arterial thrombosis due to Toxic Shock Syndrome | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/18/2019 | 19-CA-006360 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 5/12/2020 | ||||
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 | |||||
5/12/2020 |
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 | $21,134 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $8,239 | ||||||||||||||||||||
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. |
Does Dr. NIHARIKA SAMTANI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NIHARIKA SAMTANI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).