| Department File Number : | M201884562 |
| Claim Number : | 37000271 |
| Date Submitted : | 3/9/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CENTURION MEDICAL LIABILITY PROTECTIVE RISK RETENTION GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-1145017 | |||||
| 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) 503 - 5704 | (888) 909 - 5304 | MMORENO@MRCG.ORG | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Carlos | M | Rey | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2975 Coral Way | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33145 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FL5047 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME81804 | Radiology - Diagnostic - Minor Surgery | ||||
| 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 | ||||
| HIALEAH HOSPITAL | 100053 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/4/2015 | 2/2/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Colon perforation following surgical repair of inguinal hernia. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient presented to ER with complaints of abdominal pain following surgical repair of inguinal hernia. A CT scan was performed and interpreted by Dr. Rey as most compatible with colon perforation. The patient was taken to surgery 3 days later for repair of the colon perforation. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis made. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient alleged there was a delay in diagnosis of the colon perforation. However, this was correctly identified on the CT scan read by Dr. Rey. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 2/5/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| 2/5/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $34,616 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $25,000 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Case was reviewed by board certified radiology expert who was supportive of Dr. Rey. | |||||||||||||||||||||
| Updates | |
| No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. CARLOS M REY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CARLOS M REY, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).