Department File Number : | M201884070 |
Claim Number : | 24175 |
Date Submitted : | 1/11/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Pediatric Physician Services, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-3425191 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Patricia | M | Condon | ||
Street Address | |||||
501 6th Avenue South | |||||
City | State | Zip | |||
St Petersburg | FL | 33701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 767 - 4287 | (727) 767 - 8597 | pcondon1@jhmi.edu |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Heinz | C | Chavez | ||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 501 6th Avenue South | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33701 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PR1116 | $3,000,000 | $9,999,999 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME88877 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
NORTHSIDE HOSPITAL | 100238 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/27/2014 | 9/24/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pain in upper extremity / pain in limb | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No procedure and/or treatment rendered causing injury | |||||
Diagnostic Code : | 729.5 | ||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Plaintiff's alleges misdiagnosis of infection, which was disputed as there was no evidence of infection. The child had been evaluated 5 days earlier for upper respiratory complaints that included a fever. A subsequent prediatrician visit on August 22, 2014 noted continued URI symptoms with labs and viral panel ordered. When the patient returned on August 25, the primary reason for the visit was right upper extremity pain. The child was sent to the ER for further evaluation of the right upper extremity including additional x-rays which were normal. The child was discharged on Motrin with a sling and instructed to return if condition worsened. | |||||
Principal Injury Giving Rise To The Claim | |||||
Child presented two days later to Northside emergency room in cardiac arrest. The child could not be revived and died with no specific cause of death as no autopsy was performed. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/18/2017 | ||||
Other Defendants Involved in this Claim | |||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
6/28/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $300,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $48,624 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Settlement without admission of liability |
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. HEINZ C CHAVEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HEINZ C CHAVEZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).