| Department File Number : | M201988392 |
| Claim Number : | CLA0458311 |
| Date Submitted : | 4/5/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 94-2301054 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Richard | Petersen | |||
| Street Address | |||||
| 4651 Salisbury Rd. #410 | |||||
| City | State | Zip | |||
| Jacksonville | FL | 32256 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 309 - 8142 | (904) 394 - 7134 | rpetersen@norcal-group.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kriti | Kumari | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1805 SE Lake Weir Ave | ||||
| City | State | Zip Code | County | ||
| Ocala | FL | 34471 | Marion | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 720599N | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME104184 | Internal Medicine - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Marion | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/29/2015 | 11/14/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient consulted with a second physician on 05/09/17 who detected a mass in the right breast which was apparently visualized on the 08/26/15 mammogram. The second physician subsequently ordered a bilateral mammogram and right breast ultrasound conducted on 05/17/17 revealing an invasive ductal carcinoma.) | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Mrs. Dush presented to Kriti Kumari MD (Internist) for a routine examination on 07/29/15. Dr. Kumari ordered a mammogram ultrasound that was performed on 08/25/15 at unrelated radiology Group in Ocala. The results of these tests apparently were never conveyed to the patient by radiology Group. The patient was seen next on 12/03/15. At that time, Dr. Kumari did not have the diagnostic ultrasound report back from radiology Group. The patient again appeared on 08/03/16 for another follow up examination. Again, Dr. Kumari's electronic records do not reflect that the diagnostic ultrasound was sent back from radiology Group. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Mrs. Dush presented to Kriti Kumari MD (Internist) for a routine examination on 07/29/15. Dr. Kumari ordered a mammogram ultrasound that was performed on 08/25/15 at unrelated radiology Group in Ocala. The results of these tests apparently were never conveyed to the patient by radiology Group. The patient was seen next on 12/03/15. At that time, Dr. Kumari did not have the diagnostic ultrasound report back from radiology Group. The patient again appeared on 08/03/16 for another follow up examination. Again, Dr. Kumari's electronic records do not reflect that the diagnostic ultrasound was sent back from radiology Group. | |||||
| 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 | 4/3/2019 | ||||
| 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 | |||||
| 4/3/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $375,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $11,086 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Circumstances of the claim were discussed with insured & risk management. | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. KRITI KUMARI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KRITI KUMARI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).