Department File Number : | M201780931 |
Claim Number : | 98950 |
Date Submitted : | 1/23/2017 |
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 | Sasha | Yamamoto | |||
Street Address | |||||
560 Davis Street | |||||
City | State | Zip | |||
San Francisco | CA | 94111 | |||
Phone | Ext | Fax | E-Mail Address | ||
(415) 735 - 2135 | syamamoto@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ketan | Patel | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2507 Harrison Avenue, Suite 200 | ||||
City | State | Zip Code | County | ||
Panama City | FL | 34205 | Bay | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL-16065166 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME76020 | Internal Medicine - No Surgery |
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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/10/2012 | 2/13/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Treatment for his Antiphospholipid Antibody Syndrome | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Information not provided at the time of this report | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Information not provided at the time of this report | |||||
Principal Injury Giving Rise To The Claim | |||||
Disputed Allegation made by a 33 year old male with history of Antiphospholipid Antibody Syndrome, who alleges negligent administration of Xarelto instead of Coumadin resulting in a 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 | ||||
6/10/2015 | 2015-CA-631 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Bay | 10/28/2016 | ||||
Other Defendants Involved in this Claim | |||||
Lu, Kun F | |||||
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 | |||||
8/4/2016 |
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 | $0 | ||||||||||||||||||||
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 repersentative |
Updates | |
No updates found. |
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Does Dr. KETAN PATEL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KETAN PATEL, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).