Department File Number : | M202092291 |
Claim Number : | 71180 |
Date Submitted : | 4/22/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mercedes | Pressley | |||
Street Address | |||||
3535 Piedmont Road NE | |||||
City | State | Zip | |||
Atlanta | GA | 30305 | |||
Phone | Ext | Fax | E-Mail Address | ||
(404) 842 - 5600 | MPressley@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Felipe | E | Dominguez | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3030 Venure Lane, Ste. 108 | ||||
City | State | Zip Code | County | ||
Melbourne | FL | 32935 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1601952 12 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME48985 | Pathology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Not in inpatient facility | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/10/2017 | 11/28/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Not available | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Our insured failed to diagnose carcinoma on bladder biopsies resulting in 1-year delay in treatment resulting in death | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to conduct an adequate analysis of tissue. Failure to communicate with urologist | |||||
Principal Injury Giving Rise To The Claim | |||||
Death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/13/2020 | 05-20109-CA-025798 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 4/14/2020 | ||||
Other Defendants Involved in this Claim | |||||
Zabinski, Peter p Health First Medical Group, LLC Health First Physicians, Inc. Hagloch, Jay M Suncoast Pathology Associates, Inc. Doctor's Surgical Partnership, LTD | |||||
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 | |||||
4/14/2020 |
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 | $37,334 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,021 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Risk Management has counseled insured |
Updates | |
No updates found. |
Does Dr. FELIPE E DOMINGUEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FELIPE E DOMINGUEZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).