Department File Number : | M201575913 |
Claim Number : | 13-0114-A-11 |
Date Submitted : | 9/28/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FD INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3704679 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tamla | Lloyd | |||
Street Address | |||||
4651 Salisbury Road, Suite 410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32211 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 296 - 2887 | 212 | (904) 296 - 1245 | tlloyd@fdinsurancecompany.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Rafael | Rivas-Chacon | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3200 SW 60th Court, Suite 105 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33155 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
CM01000164 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME48624 | Rheumatology - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
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 | ||||
Other | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
9/14/2011 | 5/21/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient was referred to the insured by her pediatrician due to back pain, which began in March 2010 and new symptoms of arm and leg pain beginning in August 2010. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured ordered x-rays and labs for the patient when she first saw him on December 10, 2010. The insured also ordered a bone scan which the pt never had done. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
A misdiagnosis was not made. | |||||
Principal Injury Giving Rise To The Claim | |||||
Delay in diagnose of spinal cancer. | |||||
Severity Of Injury | |||||
Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/1/2014 | 13-2014-CA-012376 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 8/31/2015 | ||||
Other Defendants Involved in this Claim | |||||
Saltzman, Tanis, Pittell, Levin & Jacobson, PA De La Rua, Mairim D Romano-Silva, Amada Diaz, Margoth Perello, Robert Ramos-Arias, Yadira Yadira Ramos-Arias, MD, PA, Sheridan Emergency Physician Services, Inc. Variety Children's Hospital Baitner, AVI C Rafael Rivas-Chacon, MD, LLC Pediatric Associates, PA Pediatric Associates Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $56,593 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
The circumstances of this case were discussed with the insured and risk management was notified. Risk management discussed the case with the insured. |
Updates | |
No updates found. |
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Does Dr. RAFAEL RIVAS-CHACON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RAFAEL RIVAS-CHACON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).