| Department File Number : | M201988870 |
| Claim Number : | SAM-IG-007119 |
| Date Submitted : | 5/22/2019 |
| 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 | Edgar | A | Marin | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 975 Baptist Way | ||||
| City | State | Zip Code | County | ||
| Homestead | FL | 33033 | Monroe | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SPL 1060 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME93016 | Emergency Medicine - No Major Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Monroe | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| HOMESTEAD HOSPITAL (DADE) | 100125 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 12/26/2015 | 6/8/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Degeneration of lumbar intervertebral disc and sciatic as well as lumbar post-laminectomy syndrome. He was instructed to follow-up with his neurosurgeon. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| There was no operation, diagnostic or treatment procedure rendered causing the injury. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| There was no misdiagnosis of the patient. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| This physician initially saw the patient in the ED and then care was transferred at change of shift. Ten days after seen in the ED, the patient was admitted to the hospital with a diagnosis of cauda equina syndrome and underwent a laminectomy. He had not followed up with his neurosurgeon as instructed. Although expert reviews were supportive of this case, it was settled without an admission of liability as a business decision to protect this practitioner from potential personal excess exposure. | |||||
| Severity Of Injury | |||||
| Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 10/20/2016 | 2016-026349-CA-01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 3/19/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Homestead Hospital Sanchez, Miriel | |||||
| 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 | |||||
| 3/14/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $429,672 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $24,116 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Case discussed with defense counsel and claim consultant. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201885179 |
| Claim Number : | SAM-IG-007387 |
| Date Submitted : | 4/27/2018 |
| 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 | Edgar | Marin | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 975 Baptist Way | ||||
| City | State | Zip Code | County | ||
| Homestead | FL | 33033 | Monroe | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SPL 1060 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME93016 | Emergency Medicine - No Major Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Monroe | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| HOMESTEAD HOSPITAL (DADE) | 100125 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/30/2015 | 2/13/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Complaints of generalized swelling and rash due to possible allergic reaction to mango. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| There was no operation, diagnostic or treatment procedure that caused injury. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Allergic reaction versus drug induced rash caused by home medication (Lamictal) prescribed by the patient's treating psychiatrist. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient was diagnosed with Stevens Johnson Syndrome which evolved into Toxic Epidermal Necrolysis (TEN) secondary to a drug induced allergic reaction. Her attorney alleged a failure to timely diagnose and treat Stevens Johnson Syndrome. | |||||
| Severity Of Injury | |||||
| Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 3/8/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Fernandez, Fernando Homestead Hospital South Dade Medical Group Baptist Hospital | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 2/22/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $125,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $1,601 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $6,750 | ||||||||||||||||||||
| 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 claims consultant. | |||||||||||||||||||||
| 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.
| Department File Number : | M201678627 |
| Claim Number : | SAM-IG-005464 |
| Date Submitted : | 6/5/2016 |
| 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 | Edgar | Marin | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 975 Baptist Way | ||||
| City | State | Zip Code | County | ||
| Homestead | FL | 33030 | Monroe | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SPL 1060 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME93016 | Emergency Medicine - Including Major Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Monroe | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| HOMESTEAD HOSPITAL (DADE) | 100125 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/21/2010 | 6/15/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Right lateral malleolus fracture and fractures of the posterior and lateral malleoli. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| There was no operation, diagnostic or treatment procedure rendered causing the injury. | |||||
| 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 | |||||
| Patient was seen in the ED for diagnosis of a left ankle fracture. The patient was stabilized and referred to her podiatrist for further treatment on an outpatient basis. The plaintiff's attorney alleged a failure to properly treat resulting in displaced bimalleolar fractures. This allegation was never substantiated by an expert and this lawsuit was voluntarily dismissed against this practitioner. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 10/23/2012 | 12-41100 CA 31 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 3/28/2014 | ||||
| Other Defendants Involved in this Claim | |||||
| Maederer, Mark Gershben, Darryl Frias, Juan Vega, Otto Homestead Hospital HomesteadMed, PA Mark Maederer, JR, DPM, Inc Miami Foot Center | |||||
| 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 | $33,350 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $7,228 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Not applicable. | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
Does Dr. EDGAR A MARIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. EDGAR A MARIN, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).