Department File Number : | M201575903 |
Claim Number : | 1019573-01 |
Date Submitted : | 1/28/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Susan | K | Spielman | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0340 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Robert | S | Castro | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 2950 SW 116th Ave, Unit 308 | ||||
City | State | Zip Code | County | ||
Miramar | FL | 33025 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
A11062 | $100,000 | $300,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Physician Assistant | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9102228 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WEST GABLES REHABILITATION HOSPITAL | 110041 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/24/2012 | 5/25/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right knee pain; knee replacement surgery | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Rehab hospital supervision | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to order sitter due to high risk of fall | |||||
Principal Injury Giving Rise To The Claim | |||||
Fall with right femur fracture | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/9/2014 | 14-23253 CA 04 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 9/15/2015 | ||||
Other Defendants Involved in this Claim | |||||
West Gables Rehabilitation Hospital LLC Vargas MD, Jose L Jose L Vargas MD PA | |||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Not Pursued | ||||
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 | $14,048 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,196 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | ||||||||||
Date of Change: | 1/28/2016 9:18:55 AM | |||||||||
Reason for Change: | ALE UPDATE 1/28/2016 | |||||||||
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Does Dr. ROBERT S CASTRO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ROBERT S CASTRO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).