| Department File Number : | M201677020 |
| Claim Number : | FL0417 |
| Date Submitted : | 2/4/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 74-3129288 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Yvette | de la Morena | |||
| Street Address | |||||
| 1250 S. Pine Island Road Suite 300 | |||||
| City | State | Zip | |||
| Plantation | FL | 33324 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 923 - 1900 | ymorena@hugroups.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | HOSSAM | HASSANEIN | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 437-439 NW Prima Vista Blvd. | ||||
| City | State | Zip Code | County | ||
| Port Saint Lucie | FL | 34983 | St. Lucie | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 344-000 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME68679 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Martin | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| MARTIN MEMORIAL MEDICAL CENTER | 100044 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Emergency Dept | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/27/2013 | 5/11/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient presented for treatment of an altered mental status, back pain, and fever. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| No operation, diagnostic or treatment rendered caused injury | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 10/20/2015 | 15-1205CA | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Martin | 2/3/2016 | ||||
| Other Defendants Involved in this Claim | |||||
| Treasure Coast Hospitalist PL Hossam Hassanien MD PA Hassanein Clinic Inc Maltman , Michael Treasure Coast TopDoc PLLC | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Other | Voluntary Dismissal | ||||
| 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 | $13,821 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussed with insured. | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201782894 |
| Claim Number : | FL0469 |
| Date Submitted : | 8/23/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 74-3129288 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Yvette | de la Morena | |||
| Street Address | |||||
| 1250 S. Pine Island Road Suite 300 | |||||
| City | State | Zip | |||
| Plantation | FL | 33324 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 923 - 1900 | ymorena@hugroups.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Hossam | Hassanein | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 437-439 NW Prima Vista Blvd. | ||||
| City | State | Zip Code | County | ||
| Port Saint Lucie | FL | 34983 | St. Lucie | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 344-000 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME68679 | Hospitalists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | St. Lucie | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Location unknown | ||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Location unknown | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/26/2014 | 6/21/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| AV dural fistula | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Alleged failure to diagnose AV fistula | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Paralysis | |||||
| 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 | 7/11/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Adili, Tagrid | |||||
| 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 | |||||
| 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 | $20,290 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussed with insured. | |||||||||||||||||||||
| 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. HOSSAM HASSANEIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. HOSSAM HASSANEIN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).