| Department File Number : | M201883968 |
| Claim Number : | SAM-IG-007503 |
| Date Submitted : | 1/4/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-3433505 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | NANCY | CARR | |||
| Street Address | |||||
| 11440 SW 88th STREET | |||||
| City | State | Zip | |||
| MIAMI | FL | 33176 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Abilio | Coello | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 8900 North Kendall Drive | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33176 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SPL 1064 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME26862 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BAPTIST HOSPITAL OF MIAMI | 100008 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/8/2015 | 5/18/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Blood clot in the left arm. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Exploration of the brachioaxillary artery with embolectomy and exploration of the brachial artery and embolectomy. The following day, exploration and thromboembolectomy of the left brachial, radial and ulnar arteries with bein patch and angioplasty of the ulnar and radial arteries. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis of this patient. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient underwent surgery for left arm exploration of the brachioaxillary artery with embolectomy and exploration of the brachial artery and embolectomy. The following day, the patient again underwent surgery for left arm exploration and thromboembolectomy of the left brachial, radial, and ulnar arteries with vein patch and angioplasty of the ulnar and radial arteries for an ischemic left hand that was paralyzed. Subsequently, the patient developed left arm ischemic gangrene and underwent amputation of the left forearm. The plaintiff's attorney alleged failure to perform a bypass allegedly led to gangrene and the patient's ultimate loss of limb. This claim was settled as a business decision without an admission of liability. | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 11/16/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Steed, Thomas Tsoukas, Athanassios Baptist Hospital Mariners Hospital | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 12/12/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $4,038 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $20,978 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Not applicable. | |||||||||||||||||||||
| Updates | |
| No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
| Department File Number : | M201680250 |
| Claim Number : | FP3649601 |
| Date Submitted : | 11/9/2016 |
| 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 | Abilio | A | Coello | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1321 NW 14th Street, #306 | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33125 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FP-99409 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME26862 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BAPTIST HOSPITAL OF MIAMI | 100008 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 8/22/2007 | 12/10/2007 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Glandular tissue in the bilateral axillae. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The patient underwent surgery for excision of skin, fat and supernumerary breast tissue in both axillae. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient has a complication of brachial plexus, ulnar nerve and musculocutaneous nerve of her right hand. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/26/2010 | 10-18254-CA-01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 10/19/2016 | ||||
| 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 | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Other | Dismissal | ||||
| 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 | $37,189 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $26,598 | ||||||||||||||||||||
| 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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ABILIO COELLO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ABILIO COELLO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).