Department File Number : | M201575634 |
Claim Number : | FP4214902 |
Date Submitted : | 8/25/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Vimal | Shah | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1 Tampa General Circle, Suite A237 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33606 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-CL098098 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME89402 | Anesthesiology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
TAMPA GENERAL HOSPITAL | 100128 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/2/2009 | 9/6/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was transferrd to Tampa General Hospital with a fracture of the left ramus of the mandible. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Open reduction and internal fixation of the mandible fracture and maxillomandibular fixation. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged delay in the diagnosis and treatment of post operative breathing difficulty and pulmonary edema. | |||||
Principal Injury Giving Rise To The Claim | |||||
Death of 19 year old single female with a 20 month old son. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/27/2012 | 12-00849 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 7/29/2015 | ||||
Other Defendants Involved in this Claim | |||||
Doyle, John Beeni, Abd Moya, Jacinto Quatman, William Tampa General Hospital | |||||
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 | |||||
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 | $19,178 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $12,204 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
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Department File Number : | M202093144 |
Claim Number : | 326427 |
Date Submitted : | 8/3/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | VIMAL | V | SHAH | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 400 N. Ashley Drive, Suite 1625 | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33602 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
919546 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME89402 | Anesthesiology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
TAMPA GENERAL HOSPITAL | 100128 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/3/2013 | 1/22/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
L4-L5 lumbar back pain. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
L4-L5 laminectomy and fusion | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged improper positioning and pressure relief during lumbar back surgery resulting in compression 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 | ||||
8/21/2015 | 15-CA-7478 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 7/28/2020 | ||||
Other Defendants Involved in this Claim | |||||
Myers , Justin B Florida Health Sciences Center, Inc d/b/a Tampa General Hosp Gulf-To-Bay Anesthesiology Associates, LLC | |||||
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 | |||||
7/28/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $30,924 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $24,759 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
Does Dr. VIMAL SHAH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. VIMAL SHAH, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).