Department File Number : | M201989309 |
Claim Number : | 62392/94 |
Date Submitted : | 7/12/2019 |
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 | (404) 842 - 3319 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Carlos | Lopez | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 215 Grand Ave | ||||
City | State | Zip Code | County | ||
Coral Gables | FL | 33133 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1603468 0 0 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME93502 | Neonatal/Perinatal Medicine |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MERCY HOSPITAL, INC. | 100061 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Nursery | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/27/2015 | 6/12/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Persistent pulmonary hypertension (PPHN) | |||||
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 properly treat PPHN and transfer to another hospital for additional treatment | |||||
Principal Injury Giving Rise To The Claim | |||||
Permanent brain injury | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/13/2017 | 2017-024199-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 6/14/2019 | ||||
Other Defendants Involved in this Claim | |||||
Del Valle, MD, Kara M South Dade Neonatology | |||||
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 | |||||
6/14/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $500,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $23,195 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,036 | ||||||||||||||||||||
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. |
Department File Number : | M201677406 |
Claim Number : | FL0263 |
Date Submitted : | 3/1/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
74-3129288 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Yvette | de la Morena | |||
Street Address | |||||
1250 S. Pine Island Road Suite 300 | |||||
City | State | Zip | |||
Plantation | FL | 33324 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 923 - 1900 | ymorena@hugroups.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | CARLOS | LOPEZ | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 10332 186 Court South | ||||
City | State | Zip Code | County | ||
Boca Raton | FL | 33498 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
226-023 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME93502 | Neonatal/Perinatal Medicine |
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 | ||||
Patient's Home | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Patients Home | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/11/2009 | 11/5/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Mother found patient on her crib on prone position, unresponsive, apneic, limp, facial cyanosis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Estate alleges a failure to treat infection to test for apnea, failure to recognize increase risk of suffering micro aspirations and reflux. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Death of patient | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/4/2011 | 11-10376 CA 9 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 1/18/2016 | ||||
Other Defendants Involved in this Claim | |||||
Lifemark Hospitals of Florida dba Palmetto General Hospital Hernandez, Leonel Oliver, Maria de Lourdes Zeno, Mayra | |||||
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 | |||||
1/29/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $121,250 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $47,289 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Discussed with insured |
Updates | |
No updates found. |
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Does Dr. CARLOS LOPEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CARLOS LOPEZ, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).