Department File Number : | M202091502 |
Claim Number : | 19-44268 |
Date Submitted : | 2/17/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
THE HEALTHCARE UNDERWRITING COMPANY, A RISK RETENTION GROUP | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-2837805 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Barbara | Stauffer | |||
Street Address | |||||
14201 N. DALLAS PARKWAY | |||||
City | State | Zip | |||
DALLAS | TX | 75254 | |||
Phone | Ext | Fax | E-Mail Address | ||
(469) 893 - 6064 | BARBARA.STAUFFER@TENETHEALTH.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | GIANCARLO | PEREZ | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 7100 WEST 20TH AVENUE, SUITE 107 | ||||
City | State | Zip Code | County | ||
HIALEAH | FL | 33013 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
RRG-2018/19 -1 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME132542 | Surgery - Neurology - Including Child |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
PALMETTO GENERAL HOSPITAL | 100187 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/25/2018 | 6/11/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Mr. Harrell presented with generalized weakness and aches for three months with difficulty ambulating and gripping the right hand as well as numbness in the lower extremities. Mr. Harrell had a history of polysubstance abuse. The patient¿s work-up revealed symptomatic multilevel degenerative disc disease and ligamentous hypertrophy resulting in cord compression, effacement of the ventral thecal sac and moderate neuroforaminal narrowing. The patient was diagnosed with severe myelopathy due to cervical spondylosis with cord compression. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient underwent bilateral laminectomies and fusion of the vertebral bodies of C4-7 with decompression of the spinal cord. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO MISDIAGNOSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
INCOMPLETE QUADRIPLEGIA | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 1/15/2020 | ||||
Other Defendants Involved in this Claim | |||||
BUSTAMANTE, DO, JENNIFER MENDOZA, M.D., OTTO | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/7/2020 |
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 | $37,222 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
REVIEW OF TIMING OF PHYSICIAN NOTES |
Updates | |
No updates found. |
Does Dr. GIANCARLO PEREZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GIANCARLO PEREZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).