Department File Number : | M201884765 |
Claim Number : | EMC-FL-15-324775 |
Date Submitted : | 3/22/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EmCare Holdings, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
75-173235 | SI | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
1900 W. LOOP S., STE. 1500 | |||||
City | State | Zip | |||
Houston | TX | 77027 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ABRAHAM | WILKS | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 1717 NORTH MAIN STREET, SUITE 5200 | ||||
City | State | Zip Code | County | ||
DALLAS | TX | 75201 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HAZ1040025381-13 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME58380 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
NORTHSIDE HOSPITAL | 100238 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/6/2014 | 1/8/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
CHEST PAIN AND SHORTNESS OF BREATH | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
SEEN IN ER | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO MISDIAGNOSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
CHEST TUBE PLACED IN WRONG PLACE. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 11/15/2017 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
2/9/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $700,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $73,972 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $14,230 | ||||||||||||||||||||
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 | |||||||||||||||||||||
UNKNOWN |
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 : | M202092456 |
Claim Number : | 164746 |
Date Submitted : | 5/15/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christina | J | Stoker | ||
Street Address | |||||
2515 PARK PLAZA, BLDG 2-3E | |||||
City | State | Zip | |||
Nashville | TN | 37203 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 1779 | (866) 715 - 7235 | christina.stoker@hcahealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ABRAHAM | WILKS | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6000 49TH ST NORTH | ||||
City | State | Zip Code | County | ||
SAINT PETERSBURG | FL | 33709 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10116 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME58380 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
NORTHSIDE HOSPITAL | 100238 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | EMERGENCY ROOM | ||||
Date of Occurrence | Date Reported to Insurer | ||||
11/21/2016 | 5/14/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
SUBSTERNAL CHEST PAIN | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EVALUATED, DISCHARGED W/CLINICAL IMPRESSION OF CHEST WALL MUSCLE STRAIN AND CHRONIC THROMBOCYTOPENIA. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
DEATH DUE TO RUPTURE AORTIC DISSECTION. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/29/2018 | 2018-02869-CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 5/15/2020 | ||||
Other Defendants Involved in this Claim | |||||
RUFFOLO, D.O., ALDO RADIOLOGY PHYSICIAN SOLUTIONS OF WEST FLORIDA | |||||
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 | |||||
4/3/2020 |
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 | $67,832 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $17,871 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
REFERRED TO RISK MANAGEMENT. |
Updates | |
No updates found. |
Medical Malpractice Closed Claims Report
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Does Dr. ABRAHAM WILKS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ABRAHAM WILKS, MD has at least 4 medical malpractice case(s), lawsuit(s), or complaint(s).