Department File Number : | M201884910 |
Claim Number : | SAM-IG-007180 |
Date Submitted : | 3/30/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3433505 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | NANCY | CARR | |||
Street Address | |||||
11440 SW 88th STREET | |||||
City | State | Zip | |||
MIAMI | FL | 33176 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ann | Hernandez | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5975 Sunset Drive, Suite 402 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SPL 1088 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS9432 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Baptist Medical Plaza at Coral Gables UC | ||||
Name of Institution | Code | ||||
BAPTIST HOSPITAL | 100093 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Baptist Medical Plaza at Coral Gables UC | ||||
Date of Occurrence | Date Reported to Insurer | ||||
9/18/2015 | 8/2/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient with history of a recent D&C due to a miscarriage presented with complaints of abdominal pain. She was diagnosed with generalized abdominal pain of unknown cause and instructed to follow-up with her OB/GYN if not better or go ER. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
There was no operation, diagnostic or treatment procedure that caused injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to diagnose an ectopic pregnancy. | |||||
Principal Injury Giving Rise To The Claim | |||||
3 days after seen in the UCC the patient was admitted to a hospital, diagnosed with a right ruptured ectopic pregnancy and hemoperitoneum resulting in laparoscopic surgery with a right salpingectomy and extensive lysis of adhesions without incident. It was subsequently learned that she had undergone an elective abortion on 08/21/15. This case was settled on behalf of this physician without an admission of liability as a business decision by the carrier in order to avoid protracted litigation. | |||||
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 | ||||
9/18/2017 | 2017-016861-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 3/7/2018 | ||||
Other Defendants Involved in this Claim | |||||
Baptist Health Medical Plaza Coral Gables Urgent Care Center Nunez, Ruben Advance Woman's Care Center, Inc. | |||||
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 | |||||
2/20/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $99,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $18,350 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $20,987 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not applicable. |
Updates | |
No updates found. |
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Does Dr. ANN HERNANDEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANN HERNANDEZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).