Department File Number : | M201884989 |
Claim Number : | 1503160101163.00 |
Date Submitted : | 4/10/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PREFERRED PROFESSIONAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-0580977 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dana | D | Henderson | ||
Street Address | |||||
11605 Miracle Hills Dr, Suite 200 | |||||
City | State | Zip | |||
Omaha | NE | 68154 | |||
Phone | Ext | Fax | E-Mail Address | ||
(402) 965 - 3236 | (402) 392 - 2673 | dhenderson@coverys.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ricardo | R | Reyes | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5333 N Dixie Hwy, #205 | ||||
City | State | Zip Code | County | ||
Oakland Park | FL | 33334 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
BPP0039255 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME54512 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
Holy Cross Hospital | 100073 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Recovery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/11/2015 | 2/3/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Colon perforation, sepsis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Colonoscopy | |||||
Diagnostic Code : | 995.92 | ||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to timely administer antibiotics | |||||
Principal Injury Giving Rise To The Claim | |||||
Perforation of the ascending colon. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/6/2016 | CACE 16-018831 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 3/23/2018 | ||||
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 | |||||
4/5/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $245,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $43,556 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,972 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Be more proactive in diagnosing and treating infections. |
Updates | |
No updates found. |
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Does Dr. RICARDO R REYES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RICARDO R REYES, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).