Department File Number : | M201988316 |
Claim Number : | 000013090690 |
Date Submitted : | 3/28/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ARCH SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2545393 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jessi | Y | Chan | ||
Street Address | |||||
210 Hudson Street, Suite 300 | |||||
City | State | Zip | |||
Jersey City | NJ | 07311 | |||
Phone | Ext | Fax | E-Mail Address | ||
(201) 743 - 3898 | (201) 743 - 4005 | jchan@archinsurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Aldo | Domenichini | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3301 W. Gandy Blvd., | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33611 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HPL0002000207 | $4,000,000 | $4,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Chiropractic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME115790 | Physicians - Minor Surgery |
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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/23/2017 | 7/18/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the insured facility for complaining of back pain. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured doctor ordered an MRI which showed an L5 disc herniation on left for the patient. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
The patient alleges that the insured doctor failed to diagnose and recongnize developing blood clots in the patient's lower extrmity resulting in an emergent above the knee leg amputation. | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient alleges that the insured doctor failed to diagnose and recongnize developing blood clots in the patient's lower extrmity resulting in an emergent above the knee leg amputation. | |||||
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 | ||||
7/11/2017 | 17-CA-010189 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 5/23/2018 | ||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
7/17/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $2,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $59,036 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $226 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $2,000,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
non applicable |
Updates | |
No updates found. |
Does Dr. ALDO DOMENICHINI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ALDO DOMENICHINI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).