Department File Number : | M201884889 |
Claim Number : | MM268633 |
Date Submitted : | 3/29/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EVANSTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2950161 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | CRYSTAL | L | ALSTONBAYTON | ||
Street Address | |||||
4600 COX ROAD | |||||
City | State | Zip | |||
GLEN ALLEN | VA | 23060 | |||
Phone | Ext | Fax | E-Mail Address | ||
(804) 864 - 3731 | (855) 662 - 7535 | CALSTONBAYTON@MARKELCORP.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | PRAVEEN | CHERIPALLI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | WEST 8TH ST | ||||
City | State | Zip Code | County | ||
JACKSONVILLE | FL | 32209 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MM823736 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME104859 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
SHANDS HOSPITAL | 100113 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/21/2013 | 11/6/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
FL notice of potential claim arising out of Patient was admitted on Sept. 21, 2013 with a sore throat, inability to swallow, drooling, difficulty in speaking for the past 3 days and he was unable to take antibiotics orally. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient expired on Sept. 29, 2013 with a final diagnosis of peritonsillar abscess, cardiac arrest and anoxic encephalopathy. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO MISDIAGNOSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
FAILURE TO TREAT FOR PERITONSILLAR ABSCESS S/P PATIENT'S DEATH | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/11/2015 | 16-2015-CA-006808 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 11/3/2017 | ||||
Other Defendants Involved in this Claim | |||||
HOSPITALISTS MANAGEMENT GROUP LLC JIMENEZ, ENRIQUE L AL ASHHAB, AIHAM | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
11/15/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $750,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $143,796 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $11,489 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $63,911 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
NONE |
Updates | |
No updates found. |
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Does Dr. PRAVEEN CHERIPALLI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PRAVEEN CHERIPALLI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).