Department File Number : | M201781727 |
Claim Number : | 144351 |
Date Submitted : | 2/13/2018 |
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 | Anjan | Shah | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 305 E Brandon Blvd. | ||||
City | State | Zip Code | County | ||
Brandon | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10109 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME100905 | Surgery - Orthopedic | 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 | ||||
LAWNWOOD REG. MED. CTR | 100246 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/12/2009 | 7/26/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Left shoulder fracture. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
After ORIF surgery of left humerus, patient became unresponsive. Code Blue was called. Patient had ventricular fibrillation, was resuscitated & put on mechanical ventilation. Physician felt that cardiac arrest was caused from torsades de pointes due to severe hypomagnesemia. At this time, family advised that patient had history of alcohol abuse. Torsades de pointes is associated with chronic alcohol use. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Anoxic brain injury. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/11/2011 | 562011CA000870 | ||||
County Suit Filed in | Date of Final Disposition | ||||
St. Lucie | 3/21/2017 | ||||
Other Defendants Involved in this Claim | |||||
St. Lucie Anesthesia Specialists Reddy, M.D., Kambam R Callen, CRNA, Scott S Averbach, M.D., Joseph B St. Lucie Emergency Group, LLC The Schumacher Group of Florida, Inc. Lawnwood Healthcare Specialists, LLC | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
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 | $182,448 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $94,180 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of policies and procedures. |
Updates | ||||||||||
Date of Change: | 2/13/2018 10:20:35 AM | |||||||||
Reason for Change: | Additional LAE payments made. | |||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ANJAN SHAH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANJAN SHAH, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).