| Department File Number : | M201574896 |
| Claim Number : | TH-14-LLE-275595 |
| Date Submitted : | 6/10/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| TEAM HEALTH, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 62-1562558 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kathy | A | Stockton | ||
| Street Address | |||||
| 9821 Katy Freeway | |||||
| City | State | Zip | |||
| Houston | TX | 77024 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | HEMANGINI | MEHTA | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 265 BROOKVIEW CENTRE WAY, SUITE 400 | ||||
| City | State | Zip Code | County | ||
| KNOXVILLE | TN | 37919 | Out of state | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 6797715 | $100,000 | $300,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME111801 | Emergency Medicine - No Major Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | BROWARD INSTITUTE FOR LONG TERM CARE | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/10/2014 | 10/1/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| END STAGE RENAL DISEASE | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| DIALYSIS | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| NO MISDIAGNOSIS | |||||
| Principal Injury Giving Rise To The Claim | |||||
| DELAY IN DIALYSIS | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 1/27/2015 | 15-000806 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 5/26/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim subject to arbitration, but settlement reached in lieu of award. | |||||
| Date of Payment | |||||
| 3/19/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $11,976 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $400 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| UNKNOWN | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201678420 |
| Claim Number : | 7933940510US |
| Date Submitted : | 5/16/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| LEXINGTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-1149494 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | carolyn | r | ewell | ||
| Street Address | |||||
| 17200 W 119th St | |||||
| City | State | Zip | |||
| Olathe | KS | 66061 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (913) 495 - 4217 | carolynranee.ewell@aig.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Hemangini | Mehta | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 14050 NW 14th St STE 190 | ||||
| City | State | Zip Code | County | ||
| Sunrise | FL | 33323 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 6797715 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME111801 | Emergency Medicine - Including Major Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| BROWARD GENERAL MEDICAL CENTER | 100039 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/10/2014 | 10/1/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| FEMALE PATIENT ALLEGING DELAY IN TREATMENT OF DIALYSIS RESULTING IN DEATH. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| FEMALE PATIENT ALLEGING DELAY IN TREATMENT OF DIALYSIS RESULTING IN DEATH. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| FEMALE PATIENT ALLEGING DELAY IN TREATMENT OF DIALYSIS RESULTING IN DEATH. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| FEMALE PATIENT ALLEGING DELAY IN TREATMENT OF DIALYSIS RESULTING IN DEATH. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/19/2015 | CACE 15-000806 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 5/13/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | ||||
| No Court Proceedings. | |||||
| 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 | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $6,755 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
Does Dr. HEMANGINI MEHTA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HEMANGINI MEHTA, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).