| Department File Number : | M201676972 |
| Claim Number : | MM271856 |
| Date Submitted : | 1/29/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| EVANSTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2950161 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Dion | L | Bradford | ||
| Street Address | |||||
| 4600 Cox Road | |||||
| City | State | Zip | |||
| Glen Allen | VA | 23060 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (804) 217 - 8816 | (855) 662 - 7535 | dbradford@markelcorp.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | HENRY | J | MATA | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 651 EAST 25TH STREET | ||||
| City | State | Zip Code | County | ||
| HIALEAH | FL | 33013 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MM824097 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME102069 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| HIALEAH HOSPITAL | 100053 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/6/2013 | 7/21/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| THE PLAINTIF, A 38 YEAR-OLD PREGNANT WOMAN PRESENTED ON 2 OCCASIONS TOHIALEAH HOSPITAL'S EMERGENCY DEPARTMENT WITH UPPER RESPIRATORY COMPLAINTS & FLU-LIKE SYMPTOMS. THE FIRST PRESENTATION WAS ON 10/06/2013 AT WHICH TIME SHE WAS ASSESSED BY ELAINE SANCHEZ, P.A. (TEAM HEALTH, INC.) DR. MATA WAS THE SUPERVISING PHYSICIAN & IS LISTED AS THE ADMITTING PHYSICIAN. AT THE TIME OF HER INITIAL PRESENTATION, the PLAINTIFF WAS DOCUMENTED TO HAVE PRESENTED WITH A "SUSPICION OF INFECTION AS EVIDENCED BY COUGH/SPUTUM, FEVER (101.1º F), & TACHYCARDIA (GREATER THAN 90 BEATS PER MINUTE)." THE NURSING TRIAGE ASSESSMENT NOTE SPECIFICALLY STATES THAT THE PLAINTIFF SCREENED POSITIVE FOR SUSPICION OF "SEVERE SEPSIS." IT ALSO INDICATES THAT THE "PHYSICIAN", ELAINE SANCHEZ, P.A., WAS NOTIFIED. DURING THE COURSE OF THE INITIAL ER VISIT ON OCTOBER 6, 2013, THE PATIENT RECEIVED IV FLUIDS, TYLENOL, PROTONICS, POTASSIUM CHLORIDE, & ZITHROMAX. THE PLANITFF DIED AS A RESULT OF H1N1 WHICH WAS ALLEGEDLY NOT DIAGNOSED WHEN SHE VISITED THE EMERGENCY DEPARTMENT AT HIALEAH HOSPITAL ON 10/06/13. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| HISTORY & PHYSICAL TAKEN BY INSURED, P.A. ON 10/06/13 REFLECTED THAT PLAINTIFF (PLTF) HAD REPORTED FEVER & ONSET OF SYMPTOMS 3 DAYS EARLIER. THE PLTF WAS ALSO REPORTING A COUGH W/CLEAR SPUTUM WHICH WAS CHARACTERIZED AS "MODERATE." THE P.A. ORDERED LABS ON THE CLIAMANT INCLUDING AN INFLUENZA SCREENING. THE INFLUENZA SCREENING REFLECTED THAT BOTH INFLUENZA A AG & INFLUENZA B AG WERE BOTH NEGATIVE. THE PLTF'S LABS WERE ABNORMAL W/LOW HEMOGLOBIN & HEMATOCRIT & ELEVATED NEUTROPHILS W/ LOW LYMPHOCYTES WHICH CAN BE REFLECTIVE OF AN INFECTIOUS PROCESS. 10/06/13 PRESENTATION IS THE FACT THAT THE PLTF WAS NOT GIVEN TAMIFLU WHILE IN THE ER DEPT NOR WAS AN OBSTETRICAL CONSULT CALLED IN THAT PLTF WAS APPROXIMATELY 38 WKS PREGNANT. ADDTIONALLY TAMIFLU IS NOT GIVEN IN THE ER DEPT THE PLTF WAS GIVEN A PRESCRIPTION FOR IT AT THE TIME OF HER DISCHARGE. SHE WAS APPROX 38 WKS PREGNANT. THE PLTF WAS DISCHARGED W/OUT HAVING A CHEST X-RAY, SEEING AN OBSTETRICIAN & BEING GIVEN TAMIFLU IN THE FACE OF FLU-LIKE SYMPTOMS & PREGNANCY. THE PLTF PRESENTED AGAIN TO THE ER DEPT AT HIALEAH HOSPITAL 5 DAYS LATER ON 10/11/13. THIS TIME SHE WAS PRESENTING W/THE SAME FLU-LIKE SYMPTOMS & AN ADDITIONAL SYMPTOM OF SHORTNESS OF BREATH. A CHEST X-RAY WAS ORDERED (BY DR. MATA) FOR THE PLTF & IT SHOWED THE PRESENCE OF AN INFILTRATE. THE PRESENCE OF THE INFILTRATE PROMPTED THE ADMISSION OF THE PLTF TO THE HOSPITAL. 2 DAYS FOLLOWING THE ADMISSION ON 10/13/13 AN EMERGENCY C-SECTION WAS PERFORMED & THE PLTF DELIVERED A BABY GIRL. THE PLTF DEVELOPED ARDS, RESPIRATORY FAILURE & ULTIMATELY DIED. TRANSFERRED TO ANOTHER HOSPITAL ON 10/20/13 & DIED ON 11/03/13. SHE WAS ON MECHANICAL VENTILATION DUE TO ACUTE RESPIRATORY DISTRESS SYNDROME & HAD AN ADDITIONAL DIAGNOSIS OF VIRAL INFECTION (H1N1) & COMMUNITY ACQUIRED PNEUMONIA & PERIPARTUM CARDIOMYOPATHY. SHE CODED AND WAS RESUSCITATED. AS CAUSES OF DEATH THE HOSPITAL RECORD INDICATE ARDS, H1N1 & RESPIRATORY FAILURE. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| PLAINTIFF ALLEGES THAT H1N1 WAS NOT DIAGNOSED WHEN SHE VISITED THE EMERGENCY DEPARTMENT AT HIALEAH HOSPITAL ON OCTOBER 6, 2013. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| PLAINTIFF ALLEGES THAT H1N1 WAS NOT DIAGNOSED WHEN SHE VISITED THE EMERGENCY DEPARTMENT AT HIALEAH HOSPITAL ON OCTOBER 6, 2013. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 3/19/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| SANCHEZ, ELAINE TEAM HEALTH, INC. | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Settlement Reached Prior to Pre-Suit Period | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 11/19/2014 | |||||
| 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 | $13,647 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,619 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $5,000 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| NONE | |||||||||||||||||||||
| 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. HENRY J MATA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HENRY J MATA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).