Department File Number : | M201783645 |
Claim Number : | SAM-IG-007209 |
Date Submitted : | 11/15/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3433505 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | NANCY | CARR | |||
Street Address | |||||
11440 SW 88th STREET | |||||
City | State | Zip | |||
MIAMI | FL | 33176 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Gerardo | Diaz | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5975 Sunset Drive | ||||
City | State | Zip Code | County | ||
South Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SPL 1088 | $250 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME103459 | Pediatrics - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | Urgent Care Center at Miami Lakes | ||||
Name of Institution | Code | ||||
BAPTIST HOSPITAL | 100093 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Miami Lakes Urgent Care Ctr | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/29/2016 | 9/2/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Back pain associated with muscle strain and moderate intraventricular conduction. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
There was no operation, diagnostic or treatment procedure rendered that caused injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to diagnose and/or consider an aortic dissection in the differential diagnosis and transfer the patient to a hospital. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient was given prescriptions for Mobic and Flexeril and instructions to follow-up with a cardiologist within 2 days. He was given a 3 page list of cardiologists to select a physician. After leaving the urgent care center, the patient suffered a cardiac arrest while showering at home and expired. An autopsy ruled the cause of death as hemopericarium and right hemothorax due to a ruptured aortic dissection. This case was settled without an admission of liability in order to avoid personal exposure to this physician and as a business decision in order to avoid protracted litigation. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 4/7/2017 | ||||
Other Defendants Involved in this Claim | |||||
Urgent Care Center at Miami Lakes | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After arbitration is initiated or prior to suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
3/28/2017 |
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 | $23,660 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $8,128 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not applicable. |
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. GERARDO DIAZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GERARDO DIAZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).