Department File Number : | M201576133 |
Claim Number : | FP3827401 |
Date Submitted : | 10/21/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W. Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Franklin | COFRESI MEJIA | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1555 Indian River Building, Suite B120 | ||||
City | State | Zip Code | County | ||
Aventura | FL | 33180 | Indian River | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-98545 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME90749 | Anesthesiology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Indian River | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
INDIAN RIVER MEMORIAL HOSPITAL | 100105 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/17/2007 | 9/28/2007 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right shoulder rotator cuff tear. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Right shoulder arthroscopy. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient arrest during intubation, CPR successful but surgery was cancelled. Patient developed multi system organ failure and died in ICU five days post-op. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/21/2009 | 312009CA011618 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Indian River | 10/14/2015 | ||||
Other Defendants Involved in this Claim | |||||
Indian River Memorial Hospital | |||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Voluntary Dismissal with prejudice for the def. | ||||
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 | $117,236 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $80,647 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
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. FRANKLIN COFRESI MEJIA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FRANKLIN COFRESI MEJIA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).