| Department File Number : | M201677256 |
| Claim Number : | 149487 |
| Date Submitted : | 1/30/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTH CARE INDEMNITY, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 61-0904881 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Teresa | Ross | |||
| Street Address | |||||
| One Park Plaza P.O. Box 555 | |||||
| City | State | Zip | |||
| Nashville | TN | 37202 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Darius | Taylor | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2020 59th Street West | ||||
| City | State | Zip Code | County | ||
| Bradenton | FL | 34209 | Manatee | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HCI-10113 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Other | Physician Assistant | ||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PA9104223 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Manatee | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BLAKE MEDICAL CENTER | 100213 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/1/2013 | 5/20/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Severe aortic stenosis. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient underwent aortic valve replacement on 2/1/13. Following discharge, patient developed a non-healing sternal wound infection. On 4/3/13, patient underwent an excisional debridement of sternal wound & a long 25cm suture that had not been removed from previous aortic valve replacement surgery was retrieved. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Retained suture material, sternal wound dehiscence with infection. | |||||
| 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 | 2/8/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Riverview Cardiac Surgery Golino, M.D., Alessandro | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| No Payment Made | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| 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 | $33,037 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $4,294 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Review of policies and procedures. | |||||||||||||||||||||
| Updates | |||||||||||||
| Date of Change: | 1/30/2017 11:18:11 AM | ||||||||||||
| Reason for Change: | Additional LAE payments made. | ||||||||||||
| |||||||||||||
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. DARIUS TAYLOR, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DARIUS TAYLOR, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).