Department File Number : | M201780923 |
Claim Number : | 158414-2 |
Date Submitted : | 12/21/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jaime | Altamirano-Salazar | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 11760 SW 40th Street Suite 335 | ||||
City | State | Zip Code | County | ||
Miami | FL | 33175 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10116 | $250,000 | *NR | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME45612 | Surgery - Cardiovascular Disease | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
COLUMBIA KENDALL MEDICAL CENTER | 100209 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/21/2016 | 6/7/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Cardiac arrest. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Allege delay in performing a cardiology consult &then performing a cardiac catheterization resulted in death. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 1/9/2017 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/4/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $93,750 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $8,609 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,545 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $87,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of policies and procedures. |
Updates | ||||||||||
Date of Change: | 12/21/2017 1:22:03 PM | |||||||||
Reason for Change: | Additional LAE payments made. | |||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. JAIME ALTAMIRANO-SALAZAR, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JAIME ALTAMIRANO-SALAZAR, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).