Department File Number : | M201782268 |
Claim Number : | 145994 |
Date Submitted : | 6/9/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICUS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-5623491 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dionysia | Lawson | |||
Street Address | |||||
560 Davis Street | |||||
City | State | Zip | |||
San Francisco | CA | 94111 | |||
Phone | Ext | Fax | E-Mail Address | ||
(415) 735 - 2013 | (415) 735 - 2097 | dlawson@norcalmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Irfan | Imami | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1250 S. Harbor City Blvd | ||||
City | State | Zip Code | County | ||
Melbourne | FL | 32901 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL-16035757 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME91536 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Brevard | ||||
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 | Emergency Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
9/17/2013 | 9/22/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Transient Neurological Deficits | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Transient Neurological Deficits | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Disputed allegation of premature discharge form Institution made by 62 YOM with history of high grade stenosis in right carotid artery resulting in stroke | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/2/2016 | 05-2016-CA-013655 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 5/4/2017 | ||||
Other Defendants Involved in this Claim | |||||
Palm Bay Hospital Krenzer, Robert Dontenini, Srivanas | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
5/4/2017 |
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 | $48,398 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured conferenced with attorney and claims specialist |
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.
Department File Number : | M201885052 |
Claim Number : | 101940 |
Date Submitted : | 4/15/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICUS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-5623491 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Diane | M | McNab | ||
Street Address | |||||
4651 Salisbury St | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 439 - 0580 | dmcnab@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Irfan | R | Imami | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1140 Broadbrand Drive | ||||
City | State | Zip Code | County | ||
Melbourne | FL | 32901 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL-16035757 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME91536 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HUMANA HOSPITAL-SOUTH BROWARD | 100194 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/2/2013 | 9/9/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Restricted blood flow from hip, thigh and lower extremity resulting in below the knee amputation. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Left axillary to mid superficial femoral artery bypass | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Disputed allegation made by 60 year old male, post several bypass procedures, unable to re-vascularize, resulting in below knee amputation. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/2/2016 | 05-2016-CA-015340 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 3/9/2018 | ||||
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 not subject to Arbitration. | |||||
Date of Payment | |||||
3/13/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $99,999 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $100,674 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $100,674 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured met and conferenced with attorney and claims adjuster. |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. IRFAN IMAMI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. IRFAN IMAMI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).