| Department File Number : | M201782259 |
| Claim Number : | CLFL3998A |
| Date Submitted : | 6/9/2017 |
| 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 | First Name | MI | Last Name | ||
| Individual | LETIA | SHELTON | |||
| Street Address | |||||
| 3100 SOUTH GESSNER ROAD | |||||
| City | State | Zip | |||
| HOUSTON | TX | 77063 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (713) 353 - 1624 | LSHELTON@PROCLAIMAMERICA.COM | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | DENNIS | E | KING | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2975 CORAL WAY | ||||
| City | State | Zip Code | County | ||
| CORAL GABLES | FL | 33145 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FL3998A | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| OS8526 | Radiology - interventional | ||||
| 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 | ||||
| CORAL GABLES HOSPITAL | 100183 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/13/2014 | 11/3/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| CTA OF CHEST | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| CTA PREFORMED; FAILURE TO DIAGNOSE | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Allegations that the preliminary report failed to include the presence of free air. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| DEATH | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/17/2017 | 100000 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 3/27/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Settlement Reached Prior to Pre-Suit Period | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Award for plaintiff. | |||||
| Date of Payment | |||||
| 3/27/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $216,000 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| -UNKNOWN | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. DENNIS E KING, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DENNIS E KING, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).