Department File Number : | M201886913 |
Claim Number : | 5926401 |
Date Submitted : | 11/2/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
13-4235490 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | D | King | ||
Street Address | |||||
901 south mopac Blvd V ste 400 | |||||
City | State | Zip | |||
Austin | TX | 78746 | |||
Phone | Ext | Fax | E-Mail Address | ||
(512) 425 - 5940 | (512) 328 - 8067 | john-king@tmlt.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | AMIR | SHARIATI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5300 West Hillsboro Blvd. Ste 207 | ||||
City | State | Zip Code | County | ||
Coconut Creek | FL | 33073 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
250000 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME106332 | Surgery - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WEST BOCA MEDICAL CENTER | 110008 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/26/2015 | 11/30/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
62 year old female referred to physician as she had developed a uterine prolapse cystocele and rectocele which caused stress incontinence and urinary frequency. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Physician recommended surgery. Physician performed a di Vinci cervical hysterectomy on 10-26-2015. No complications were noted during surgery | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
4 days after being discharged from surgery, patient returned to the hospital and was subsequently diagnosed with a perforated bowel. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient underwent a bowel resection and later transferred to ICU. She developed sepsis during her hospitalization. | |||||
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 | ||||
1/9/2018 | 2018CA000306XXXXM | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 10/16/2018 | ||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
10/12/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $36,545 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $13,545 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $200,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
none-known complication of surgery |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201884034 |
Claim Number : | 59237601 |
Date Submitted : | 1/9/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
13-4235490 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | D | King | ||
Street Address | |||||
901 south mopac Blvd V ste 400 | |||||
City | State | Zip | |||
Austin | TX | 78746 | |||
Phone | Ext | Fax | E-Mail Address | ||
(512) 425 - 5940 | (512) 328 - 8067 | john-king@tmlt.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | AMIR | SHARIATI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5300 West Hillsboro Blvd. Ste 207 | ||||
City | State | Zip Code | County | ||
Coconut Creek | FL | 33073 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
138028 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME106332 | Surgery - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BOCA RATON COMMUNITY HOSPITAL | 100168 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/5/2013 | 9/23/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to physician with complaints of frequent urination due to vaginal vault prolapse | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
After confirming diagnosis and discussing treatment options, patient elected to undergo surgery. Physician performed a da Vinci assisted sacral colpopexy. No complications were noted during surgery and patient was discharged the following day | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Patient presented to emergency department three days after surgery and was discovered to have a perforated bowel. | |||||
Principal Injury Giving Rise To The Claim | |||||
As a result of complication, patient underwent multiple surgery with protracted hospitalization. | |||||
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 | ||||
2/2/2016 | 59-237601 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 12/11/2017 | ||||
Other Defendants Involved in this Claim | |||||
Mallis, michael Stricoff, Ronald Borzykowski, Ross | |||||
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 | |||||
12/1/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $215,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $114,623 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $35,420 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $150,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
known complication surgery |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201884146 |
Claim Number : | 59270001 |
Date Submitted : | 1/22/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PHYSICIANS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
13-4235490 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | D | King | ||
Street Address | |||||
901 south mopac Blvd V ste 400 | |||||
City | State | Zip | |||
Austin | TX | 78746 | |||
Phone | Ext | Fax | E-Mail Address | ||
(512) 425 - 5940 | (512) 328 - 8067 | john-king@tmlt.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | AMIR | SHARIATI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5300 West Hillsboro Blvd. Ste 207 | ||||
City | State | Zip Code | County | ||
Pompano Beach | FL | 33073 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
138028 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME106332 | Surgery - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BOCA RATON COMMUNITY HOSPITAL | 100168 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/5/2015 | 1/5/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented to reporting physician due to complaints of pelvic pain, constipation and pelvic organ prolapse. After undergoing urodynamic testing, patient elected to undergo surgery | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
On February 5, 2015, patient was admitted for surgery. Reporting physician performed a da Vinci assisted sacrocolopoexy procedure with a suburethral sling. Surgery was completed without any noted complications | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Following surgery, the patient noted no unexpected pain. The patient was discharged from the hospital the following day. The following day after discharge the patient after contacting reporting physician returned to a different hospital due to post op pain and due to unable to urinate. | |||||
Principal Injury Giving Rise To The Claim | |||||
After various tests were ordered, patient was taken back to surgery for an exploratory laparotomy. Patient was found to have a perforation in her small bowel. It was surgically repaired. | |||||
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 | ||||
4/5/2017 | 17-005860 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 1/18/2018 | ||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/8/2018 |
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 | $32,045 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,055 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $200,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Patient sustained a known complication during surgery which likely did not present itself until after surgery. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. AMIR SHARIATI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AMIR SHARIATI, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).