| Department File Number : | M201781173 |
| Claim Number : | SAM-IG-007191 |
| Date Submitted : | 2/9/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-3433505 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | NANCY | CARR | |||
| Street Address | |||||
| 11440 SW 88th STREET | |||||
| City | State | Zip | |||
| MIAMI | FL | 33176 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jonathan | Fields | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 8900 North Kendall Drive | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33176 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SPL 1064 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME75342 | Radiology - Diagnostic - 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 | ||||
| Other Location | Baptist Medical Plaza Miami Lakes UCC | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Baptist Med Plaza at Miami Lakes UCC | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/14/2014 | 8/19/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Right wrist pain/right dorsal dislocation of the right index metacarpophalangeal joint. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| There was no operation, diagnostic or treatment procedure that caused injury. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to diagnose a right dorsal dislocation of the right index metacarpophalangeal joint. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient was splinted at the Urgent Care Center and advised to see a hand surgeon the next day. She failed to follow medical advice and waited approximately 6 weeks before seeking treatment resulting in a delay in care resulting in a possible more extensive surgical procedure. This case was settled as a business decision without an admission of liability in order to avoid protracted litigation. | |||||
| Severity Of Injury | |||||
| Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 1/20/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Miami Lakes Urgent Care Center | |||||
| 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 | |||||
| 1/20/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $4,558 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $10,665 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $75,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Not applicable. | |||||||||||||||||||||
| 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. JONATHAN FIELDS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JONATHAN FIELDS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).