Department File Number : | M201781766 |
Claim Number : | 70448A |
Date Submitted : | 4/10/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | James | P | Lacey | ||
Street Address | |||||
245 Riverside Avenue, Suite 550 | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4068 | (888) 974 - 6458 | JLacey@MedMalDirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Amit | Srivastava | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5398 Park Street North | ||||
City | State | Zip Code | County | ||
Saint Petersburg | FL | 33709 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707165 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME112042 | Surgery - Cardiovascular Disease |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT ANTHONY'S HOSPITAL | 100067 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Special Procedure Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/8/2013 | 2/5/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pericardial effusion. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Pericardiocentesis. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Improperly performed procedure. | |||||
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 | 3/30/2017 | ||||
Other Defendants Involved in this Claim | |||||
Finn, John G Shah, Shalin S | |||||
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 | |||||
4/5/2017 |
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 | $120,221 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 : | M201885722 |
Claim Number : | 1044087-01 |
Date Submitted : | 8/28/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Amit | Srivastava | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1201 7th Ave N | ||||
City | State | Zip Code | County | ||
Saint Petersburg | FL | 33705 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
817170 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME112042 | Surgery - Cardiovascular Disease |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT ANTHONY'S HOSPITAL | 100067 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/2/2016 | 5/31/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Chest pain-blockage | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
left heart catheterization | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
failure of communication which led to premature discharge & late diagnosis of myocardial infarction | |||||
Principal Injury Giving Rise To The Claim | |||||
permanent & extensive damage to the heart | |||||
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 | ||||
10/20/2017 | 17-006338-CI-13 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 6/13/2018 | ||||
Other Defendants Involved in this Claim | |||||
Trinity Health Corporation Baycare Health System Inc St Anthony's Hospital Inc St Anthony's Professional Buildings and Services Inc Bay Area Heart Center PA Finn MD, John Bhatia MD, Vikas | |||||
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 | |||||
6/13/2018 |
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 | $12,326 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,724 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $222,222 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
n/a |
Updates | ||||||||||
Date of Change: | 8/28/2018 2:57:34 PM | |||||||||
Reason for Change: | ALE UPDATE | |||||||||
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This page is not displaying certain sensitive information.
Department File Number : | M201886551 |
Claim Number : | 1048872-01 |
Date Submitted : | 9/27/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Amit | Srivastava | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1201 7th Ave N | ||||
City | State | Zip Code | County | ||
Saint Petersburg | FL | 33705 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
817170 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME112042 | Cardiovascular Disease - Minor 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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT ANTHONY'S HOSPITAL | 100067 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/7/2016 | 9/22/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Abnormal nuclear stress test | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Left heart catheterization | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Inappropriate advancement of guide wire | |||||
Principal Injury Giving Rise To The Claim | |||||
Latrogenic injury of the right coronary | |||||
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 | ||||
4/26/2018 | 18-002644-CI-13 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 9/26/2018 | ||||
Other Defendants Involved in this Claim | |||||
Trinity Health Corporation Baycare Health System Inc St Anthony's Hospital Inc St Anthony's Professional Buildings and Services Inc Bay Area Heart Center PA | |||||
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 | |||||
9/26/2018 |
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 | $4,411 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,755 | ||||||||||||||||||||
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 | |||||||||||||||||||||
n/a |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. AMIT SRIVASTAVA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AMIT SRIVASTAVA, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).