Department File Number : | M201678539 |
Claim Number : | 2014000200 |
Date Submitted : | 5/23/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ALLIED WORLD SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
56-0997452 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Joyce | M | Palmisano | ||
Street Address | |||||
1690 New Britain Ave. Suite 101 | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 284 - 1382 | 1382 | (860) 284 - 1383 | Joyce.Palmisano@awac.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Francisco | Borges | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2430 NW 103rd Avenue | ||||
City | State | Zip Code | County | ||
Pembroke Pines | FL | 33026 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0001-3597 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME22643 | Physciatry - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Patient's Home | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Patient's Home | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/26/2013 | 1/7/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Mental issues and/or mental illnesses including but not limited to: depression, severe anxiety, insomnia, significant weight loss and a mood disorder. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Depression, anxiety and mood disorder treatment beginning on or around 3/19/2013. Medication regimen changed, including the addition of Doxepin. Subsequent diagnosis of bipolar disorder with insomnia. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to recognize a complication. Did not use Baker Act or attempt to schedule an earlier appointment. | |||||
Principal Injury Giving Rise To The Claim | |||||
On 4/23/2013 the provider was informed that the patient was abusing drugs and out of control. Patient was referred to mobile crisis unit. On 4/26/2013 the patient died from a possible suicide and doxepin toxicity. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/10/2016 | ||||
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 | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $192,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $19,043 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Worked closely with defense counsel to resolve claim. |
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.
Does Dr. FRANCISCO BORGES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FRANCISCO BORGES, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).