| Department File Number : | M202091018 |
| Claim Number : | 384114 |
| Date Submitted : | 1/6/2020 |
| 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 | Angela | LaFrance | |||
| Street Address | |||||
| 12724 Gran Bay Pkwy., W., Suite 400 | |||||
| City | State | Zip | |||
| JACKSONVILLE | FL | 32258 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 360 - 3045 | (707) 927 - 1809 | alafrance@thedoctors.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Angelika | L | Kharrazi | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1200 Riverplace Blvd., Suite 620 | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32207 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0734400 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME94872 | Hospitalists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Clay | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| ORANGE PARK MEDICAL CENTER | 100226 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Emergency room | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/30/2018 | 5/1/2019 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient presented to the Emergency Department with a right facial droop and slurred speech. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The insured evaluated the patient, ordered an MRI of the brain, neurological consult and Lovenox for DVT prophylaxis for possible CVA. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to order frequent neurologic monitoring and appropriately recognize the recurrent symptoms of acute ischemic stroke. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Debilitating weakness of the right leg, right arm and slurred speech. | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 10/7/2019 | 96853017 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Clay | 12/18/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Orange Park Medical Center, Inc. | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within 90 days of suit being filed. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 12/16/2019 | |||||
| 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 | $16,917 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $82,009 | ||||||||||||||||||||
| 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. |
| Department File Number : | M201678730 |
| Claim Number : | 52327 |
| Date Submitted : | 6/14/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| MAG MUTUAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 58-1449198 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | MAG MUTUAL INSURANCE COMPANY | ||||
| Street Address | |||||
| 8427 South Park Circle Suite 130 | |||||
| City | State | Zip | |||
| Orlando | FL | 32819 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Angelika | Kharrazi | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 841 Prudential Dr., Ste. 1802 | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32207 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PSL 1600517 14 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME94872 | Hospitalists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Duval | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BAPTIST MEDICAL CENTER SOUTH | 23960052 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Critical Care Unit | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 8/6/2012 | 2/12/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Low blood pressure | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| No iatrogenic injury | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to monitor vital signs | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 2/11/2015 | 2014-CA-8173 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Duval | 5/9/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Miller, MD, Robert Adams, MD, Kenneth Namen, MD, Andrew Crowe, MD, Mark Comar, MD, Kevin Farooque, MD, Mohammad Farraye, MD, Marc J Homra, MD, C M | |||||
| 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 | |||||
| No Payment Made | |||||
| 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 | $61 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,739 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Risk management has counseled insured | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. ANGELIKA L KHARRAZI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANGELIKA L KHARRAZI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).