Department File Number : | M202092361 |
Claim Number : | 390083 |
Date Submitted : | 4/29/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dawn | Owens | |||
Street Address | |||||
12724 GRAN BAY PKWY W, Suite 400 | |||||
City | State | Zip | |||
JACKSONVILLE | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3044 | dowens@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JOSE | A | MENAJOVSKY CHAVES | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 2580 Metro Centre Blvd #3 | ||||
City | State | Zip Code | County | ||
West Palm Beach | FL | 33407 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0068315 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME109354 | Infectious Diseases - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
GOOD SAMARITAN HOSPITAL | 110403 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/2/2018 | 9/24/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the ER with complaints of abdominal pain located in the right upper quadrant. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insured was called to evaluate the patient from an ID perspective for MRSA. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient was ultimately diagnosed with an epidural spinal abscess at the thoracic level and is now a paraplegic. | |||||
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 | 4/23/2020 | ||||
Other Defendants Involved in this Claim | |||||
Advanced Medical Clinic Fortier, Daniel Good Samaritan Medical Center Gooneratne, Romesh Gunwardene, Ishan JFK Medical Center Letang, Ketty Porter, JR, Ronald Radiology Physician Solution | |||||
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 | |||||
4/23/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $7,904 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $7,033 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
Department File Number : | M201782760 |
Claim Number : | 324099 |
Date Submitted : | 8/8/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JOSE | A | MENAJOVSKY CHAVES | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1515 N. Flagler Drive, Suite 200 | ||||
City | State | Zip Code | County | ||
West Palm Beach | FL | 33401 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
068315 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME109354 | Infectious Diseases - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | West Palm Hospital | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/9/2013 | 11/4/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented with weakness and altered mental state. The diagnosis was thrombotic thrombocytopenic purpura, infection and sepsis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient was treated with antibiotics. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to appropriately manage Vancomycin which contributed to the death of this 27 year old male. | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/2/2015 | 2015CA003076 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 7/25/2017 | ||||
Other Defendants Involved in this Claim | |||||
HCA, Inc. Columbia Hospital dba West Palm Hospital Krull, RN, Jamie Hanson-Leal, MD, Susan Stewart, DO, Noelle Young-Stewart, Pharmacist, Alana | |||||
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 | |||||
7/26/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $128,554 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $113,798 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
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Does Dr. JOSE A MENAJOVSKY CHAVES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOSE A MENAJOVSKY CHAVES, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).