| Department File Number : | M201680353 |
| Claim Number : | 158324 |
| 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 | Errika | Walker-Magra | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 13000 Bruce B Downs Blvd. | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33612 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HCI-10115 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME118626 | Emergency Medicine - No Major Surgery | 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 | 4/29/2016 | ||||
| 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 | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| Disposed of by Court | |||||
| 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 | $32,720 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $4,564 | ||||||||||||||||||||
| 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: | 12/5/2016 11:03:38 AM | ||||||||||||
| Reason for Change: | Additional LAE payments made. | ||||||||||||
| |||||||||||||
| Date of Change: | 10/19/2017 10:17:38 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. ERRIKA WALKER-MAGRA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ERRIKA WALKER-MAGRA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).