Department File Number : | M201680339 |
Claim Number : | 157730 |
Date Submitted : | 10/19/2017 |
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 | Enrique | Rivera | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3501 Cortez Road W | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34210 | Manatee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10115 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79810 | Surgery - Cardiac | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Sarasota | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
COLUMBIA DOCTORS' HOSPITAL-SARASOTA | 100166 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Emergency Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
3/30/2015 | 3/17/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pericarditis, myocardial infarction. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient seen in ER for chest pain. ER physician interpreted EKG as pericarditis. Patient's troponin level later rose in ER & patient later found to have 100% stenosis resulting in permanent heart muscle damage & reduced ejection fraction of 35-40%. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Ischemic cardiomyopathy. | |||||
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 | 11/14/2016 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
10/20/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $900,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $44,258 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $29,637 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $700,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of policies and procedures. |
Updates | ||||||||||
Date of Change: | 12/5/2016 11:03:38 AM | |||||||||
Reason for Change: | Additional LAE payments made. | |||||||||
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Date of Change: | 10/19/2017 10:07:53 AM | |||||||||
Reason for Change: | Additional LAE payments made. | |||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ENRIQUE RIVERA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ENRIQUE RIVERA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).