| Department File Number : | M201989342 |
| Claim Number : | 110032 |
| Date Submitted : | 7/18/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| OPHTHALMIC MUTUAL INSURANCE COMPANY (A R.R.G.) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-3047990 | |||||
| Insurer Contact Information | |||||
| Type | Entity Name | ||||
| Entity | Medical Risk Consultant Group | ||||
| Street Address | |||||
| PO Box 140457 | |||||
| City | State | Zip | |||
| Coral Gables | FL | 33114 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 445 - 3040 | (888) 909 - 5304 | MMORENO@MRCG.ORG | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Anup | Kubal | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1776 N. Pine Island Road | ||||
| City | State | Zip Code | County | ||
| Plantation | FL | 33322 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| OMC0013271 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME103910 | Surgery - Opthalmology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | surgical center | ||||
| Name of Institution | Code | ||||
| NORTH MIAMI BEACH SURGICAL CENTER | 14960423 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 8/30/2016 | 11/9/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Fungal infection OS | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient underwent DSAEK procedure OS by another physician. Subsequently it was determined the rim culture was positive for candida. Insured provided treatment for the fungal infection, however, the patient developed an endophthalmitis despite close follow-up and medical treatment. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis made. The patient was appropriately diagnosed with the fungal infection, however, treatment was not successful. Expert review revealed care was appropriate | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Loss of vision OS with subsequent enucleation | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 7/16/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Kubal, Aarup North Miami Beach Surgical Center | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 7/16/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $450,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussion with risk management personnel and medical expert review. Expert review revealed that despite appropriate treatment and close follow-up patient suffered an unfortunate outcome. | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. ANUP KUBAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANUP KUBAL, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).