| Department File Number : | M201677881 |
| Claim Number : | 152018 |
| Date Submitted : | 2/20/2017 |
| 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 | Teresa | Ross | |||
| Street Address | |||||
| One Park Plaza P.O. Box 555 | |||||
| City | State | Zip | |||
| Nashville | TN | 37202 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Anastasia | Canacci | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1210 S Old Dixie Hwy | ||||
| City | State | Zip Code | County | ||
| Jupiter | FL | 33458 | Palm Beach | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HCI-10114 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME111273 | Pathology - All Other | 01 | |||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | St. Lucie | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| COLUMBIA MED. CTR.-PORT ST. LUCIE | 100260 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Pathology | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/10/2014 | 4/23/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Right breast cancer. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| During modified radical mastectomy, six axillary lymph nodes were removed after wrongful diagnosis of malignancy. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Unnecessary removal of lymph nodes, lymphedema. | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 3/22/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| After arbitration is initiated or prior to suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim subject to arbitration, but settlement reached in lieu of award. | |||||
| Date of Payment | |||||
| 3/16/2016 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $675,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $148,551 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $37,282 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Review of policies and procedures. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 2/20/2017 9:58:54 AM | |||||||||
| Reason for Change: | Additional LAE payments made. | |||||||||
| ||||||||||
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ANASTASIA CANACCI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANASTASIA CANACCI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).