Department File Number : | M201574742 |
Claim Number : | 12-0269-A-12 |
Date Submitted : | 1/19/2016 |
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 | 32256 | |||
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 | Ramin | Abdolvahabi | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3319 State Road 7, Suite 313 | ||||
City | State | Zip Code | County | ||
Wellington | FL | 33449 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MG000177 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME90012 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Palm Beach | ||||
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 | ||||
10/29/2012 | 12/3/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
In October 2012, the patient was presented to Jupiter Medical Center for orthopedic surgery. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
On October 29, 2012, the insured performed a posterior lumbar interbody fusion and pedicle screw fixation with decompression and exploration at L3-4 and L5-S1. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None made | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged negligent surgical technique causing patient to bleed to death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/18/2013 | 2013 CA 13738 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 4/30/2015 | ||||
Other Defendants Involved in this Claim | |||||
Jupiter Anesthesia Associates, LLC Jupiter Medical Center, Inc Palm Beach Neurosurgery, LLC Rosselli, Matteo Fecht, Denise | |||||
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 | |||||
4/30/2015 |
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 | $53,170 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Circumstances of this case have been discussed with insured and risk management was notified. Risk management has discussed with insured. |
Updates | |||||||
Date of Change: | 1/19/2016 2:29:24 PM | ||||||
Reason for Change: | Updated LAE amount. | ||||||
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Department File Number : | M201884266 |
Claim Number : | Incident No: 109476 |
Date Submitted : | 2/5/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
94-2301054 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Diane | McNab | |||
Street Address | |||||
4651 Salisbury Rd, Suite 410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 439 - 0580 | dmcnab@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ramin | M | Abdolvahabi | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3319 S. State Road 7, Suite 313 | ||||
City | State | Zip Code | County | ||
Lake Worth | FL | 33449 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
720584N | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME90012 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
JFK MEDICAL CENTER | 100080 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/24/2015 | 3/2/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient had herniation/bulging discs at L4/5 and L5/S1. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Practitioner performed a bilateral L4/5 hemilaminectomy and foraminotomies, together with a left L5/S1 hemilaminectomy with foraminotomies and discectomy. Pathology reflected no infection. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
53 year old male alleged practitioner failed to recognize questionable wound infection which resulted in further procedure and aggravation of pre-existing back injury. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/1/2017 | 50-2017-CA-006137 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 1/24/2018 | ||||
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 | |||||
1/8/2018 |
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 | $58,158 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $58,158 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured conferenced with attorney and claims specialist |
Updates | |
No updates found. |
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Does Dr. RAMIN ABDOLVAHABI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RAMIN ABDOLVAHABI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).