| Department File Number : | M201885316 |
| Claim Number : | 592220401 |
| Date Submitted : | 5/16/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PHYSICIANS INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 13-4235490 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | John | D | King | ||
| Street Address | |||||
| 901 south mopac Blvd V ste 400 | |||||
| City | State | Zip | |||
| Austin | TX | 78746 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (512) 425 - 5940 | (512) 328 - 8067 | john-king@tmlt.org | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Issam | Nasr | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | Memorial Medical Parkway, Ste 2815 | ||||
| City | State | Zip Code | County | ||
| Palm Coast | FL | 32164 | Flagler | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 138353 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME109365 | Gastroenterology - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Flagler | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| HALIFAX MEDICAL CENTER | 100017 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/29/2013 | 2/5/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| 23 year old female patients presented to hospital with chief complaint of abdominal pain on June 27, 2013. She had previously presented to the same hospital in January and was discharged and had been following up with a GI. She was admitted to the hospital for observation and testing. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Numerous tests and studies as well as consults with various consults were obtain during the patient's admission in the hospital. The reporting physician was consulted during her admission. Reporting physician was actually the one who concluded the patient had Takayasu arteritis, an extremely rare condition. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Because of reporting physician's diagnosis, treatment was able to be provided to the patient. Reporting physician continued to care for the patient until July 9th at which time patient was followed by other GI. Patient condition did not improve despite treatment . Patient was eventually transferred to another hospital on July 18th, | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Despite efforts by numerous physicians, patient's condition continued to decline and patient died on July 29th. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/23/2015 | 28817984 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Volusia | 5/7/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Halifax Medical Center Advanced Gastroenterology Center, PL BRATU, BEATRICE Serbu, dan Hemaidan, Ammar | |||||
| 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 | |||||
| 5/14/2018 | |||||
| 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 | $76,430 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $11,434 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| None- Reporting physician made the diagnosis of a rare condition. Despite appropriate care by reporting physician, patient succumbed to illness | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. ISSAM NASR, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ISSAM NASR, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).