| Department File Number : | M201886521 |
| Claim Number : | SAM-IG-006300 |
| Date Submitted : | 9/21/2018 |
| 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 | Damian | Chaupin | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 7400 S.W. 87th Avenue, Suite 240 | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33176 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SPL 1013 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME103261 | Surgery - Cardiovascular Disease | ||||
| 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 | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BAPTIST HOSPITAL | 100093 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/1/2013 | 7/17/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Normal left and right ventricular systolic function, mild mitral valve regurgitation, mild thickening and calcification of the aortic valve leaflets, trace aortic valve regurgitation, trace tricuspid valve regurgitation and simple atheroma was seen in the ascending aorta, aortic arch and descending thoracic aorta. Multiple Strokes and TIAs. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Transesophageal echocardiography. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis of this patient. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Physician requested to perform a TEE by a neurologist due to concern of cardioembolic source of patient¿s strokes and ongoing TIAs. Physician was aware of two failed attempts to perform a TEE by another physician. She sustained an esophageal perforation during the TEE requiring a thoracotomy. Her attorney alleged a third attempt of the TEE was a deviation from the standard of care resulting in a perforation of the esophagus and as a result of the surgical repair she sustained damage to her vocal cords. This case went to trial and concluded in a defense verdict as the allegations were unsubstantiated. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/16/2015 | 15-005819 CA 01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 7/25/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Judgment for the defendant. | |||||
| 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 | $230,236 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $86,636 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Physician discussed case with defense counsel and claim consultant. | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. DAMIAN CHAUPIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DAMIAN CHAUPIN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).