| Department File Number : | M201574244 |
| Claim Number : | 314749 |
| Date Submitted : | 4/9/2015 |
| 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 | Abusayeed | Feroz | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 5216 Clayton Court | ||||
| City | State | Zip Code | County | ||
| Fort Myers | FL | 33907 | Lee | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FP-IN028202 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME57253 | Pulmonary Diseases - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Lee | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Lee Memorial Health System | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/9/2012 | 1/29/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| 72 year old with chronic bronchitis admitted for exacerbation. When she complained of chest pain and had elevated Troponin along with atrial fibrillation Lovenox was ordered. Patient developed retroperitoneal bleed and multi organ system failure and died. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Administration of Lovenox related to retroperitoneal bleed but firmly supported by expert review. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 8/27/2014 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| Dropped before Action Filed | |||||
| 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? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $8,583 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,406 | ||||||||||||||||||||
| 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.
| Department File Number : | M201574700 |
| Claim Number : | FP4335801 |
| Date Submitted : | 5/22/2015 |
| 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 | Abusayeed | Feroz | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3620 Broadway | ||||
| City | State | Zip Code | County | ||
| Fort Myers | FL | 33901 | Lee | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FP-IN028202 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME57253 | Pulmonary Diseases - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Lee | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| CAPE CORAL HOSPITAL | 100244 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Critical Care Unit | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/28/2011 | 7/24/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient underwent endarterectomy due to high grade stenosis of the left carotid artery. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Elective endarterectomy of left carotid artery and placement of a three way catheter for continous bladder irrigiation. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to treat decreased hematocrit and hemaglobin levels. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 11/25/2012 | 12-CA-003299 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Lee | 5/19/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| After court verdict and prior to filing of notice of appeal. | |||||
| Final Method of Claim Disposition | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Judgment for the defendant. | |||||
| 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 | $72,007 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $72,739 | ||||||||||||||||||||
| 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. |
This page is not displaying certain sensitive information.
Does Dr. ABUSAYEED FEROZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ABUSAYEED FEROZ, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).