Department File Number : | M202091631 |
Claim Number : | 2016-08509 |
Date Submitted : | 2/24/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
University of Miami Miller School of Medicine | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-062445 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | University of Miami Miller School of Medicine | ||||
Street Address | |||||
1400 NW 1oth Avenue, Suite 1101 | |||||
City | State | Zip | |||
Miami | FL | 33136 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 243 - 1408 | (305) 243 - 1404 | f.shafi@med.miami.edu |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Victor | Perez | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 900 NW 17th Street | ||||
City | State | Zip Code | County | ||
Miami | FL | 33136 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SI-0000 | $1 | $1 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME97293 | Surgery - Opthalmology |
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 Outpatient Facility | |||||
Name of Institution | Code | ||||
ANNE BATES LEACH EYE HOSPITAL | 100240 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Left Eye | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/7/2016 | 7/17/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Conjunctivitis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Prednisone Drops | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
IOP | |||||
Principal Injury Giving Rise To The Claim | |||||
Loss of Vision in Left Eye | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/1/2018 | 2018-018431-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 12/9/2019 | ||||
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 | |||||
2/5/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $1,250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $75,075 | ||||||||||||||||||||
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 | |||||||||||||||||||||
All safety management measures have been completed. |
Updates | |
No updates found. |
Does Dr. VICTOR PEREZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. VICTOR PEREZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).