| Department File Number : | M201677313 |
| Claim Number : | SM268949 |
| Date Submitted : | 2/25/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| EVANSTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2950161 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | CRYSTAL | L | ALSTONBAYTON | ||
| Street Address | |||||
| 4600 COX ROAD | |||||
| City | State | Zip | |||
| GLEN ALLEN | VA | 23060 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (804) 864 - 3731 | (855) 662 - 7535 | CALSTONBAYTON@MARKELCORP.COM | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | LIUSKA | MARISCAL | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12991 SW 112 ST | ||||
| City | State | Zip Code | County | ||
| MIAMI | FL | 33186 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SM892609 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME95687 | Pediatrics - 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 | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | PHYSICIAN'S OFFICE - COMMUNITY MEDICAL | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 12/14/2011 | 12/3/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| CLAIMANT PRESENTED TO DOCTOR WITH RASH, THEN RETURNED WITH FEVER, NASAL DISCHARGE, SORE THROAT AND PAIN TO TOUCH ON LT SIDE OF THROAT. AFTER ONE WEEK PT RETURNED WITH COMPLAINT OF LEFT EYE DRIFT. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| CLAIMANT PRESENTED TO THE INSURED AS A NEW PATIENT ON OCTOBER 19, 2011 WITH A RASH, AND DR MARISCAL ORDERED LABS. THE CLAIMANT RETURNED ON NOVER 3, 2011 WITH FEVER, CLEAR NASAL DISCHARGE, SORE THROAT ON LEFT SIDE AND PAINFUL TO TOUCH. SHE WAS GIVEN AMOXICILLIN AND ORDERED TOR ETURN IN ONE WEEK. ON NOVEMBER 10, 2011, THE FIRST NOTATION OF A COMPLAINT OF LEFT EYE DRIFT WAS NOTATED. VACCINATIONS WERE ORDERED AND AN OPHTHALMOLOGIC REFERRAL FOR A POSSIBLE DIAGNOSIS OF STRABISMUS. ON NOVEMBER 29, 2011 DR MARISCAL SIGNED OFF ON A REFERRAL FOR THE CLMT TO BE SEEN BY AN OPTHAMOLAGIST. ON DECEMBER 14, 2011 CLMT SAW OPTHAMOLOGIST WHO RECOMMENDED MRI D/T LT OPTIC NEUROPATHY. DR FAXED THIS INFO TO INSD ATTENTION DR GOMEZ WHO HAD NOT SEEN CLAIMANT BEFORE. NEITHER DR GOMEZ OR DR MARISCAL CLAIM TO HAVE SEEN THIS ORDER UNTIL JANUARY 2013. DR GOMEZ SAW CLMT ON SEPT 12, 2012 AS F/U FOR DIAGNOSIS OF STRABISMUS. DR NOTES MILD LATERAL DEVIATION OF LT EYE AND NO LESION. RECOMMENDED F/U WITH OPTHAMOLOGIST TO CONTINUE CARE WITH ADVISE AND COUNSEL TO CLMT¿S MOTHER. ON OCT 16, 2012 CLMT RETURNED TO INSD WITH FEVER FOR 3 DAYS, COUGH AND RUNNY NOSE. OTHER THAN ABNORAL NOTATION FOR LEFT EY AND NOTATION OF STRABISMUS NO MENTION OF BRAIN MRI OR STATUS OF F/U MADE. ON NOV 3, 2012 DR GOMEZ REQ REF TO OPTHAMOLOGIST FOR REEVAL. ON NOV 20, 2012 CLMT RETURNED TO DR MARISCAL FOR POOR SCHOOL PERFORMANCE. NOTATION MADE ABOUT LEFT EYE. NO MENTION OF REFERAL TO OPTHAMOLOGIST. VISIT FOR VACCINES AND PSYCH REFERRAL. ON DEC 6 2012 CLMT SEEN BY OPTHAMOLOGIST WHO FAXED REPORT TO DR GOMEZ RECOMMENDING MRI WITH RX. IT WAS STAMPED REC¿D ON DEC 11 2012 & PAPERWORK APPROVING THE MRI. IT WAS NOT UNTIL JAN 22, 2013 THE MRI WAS ORDERED BY THE OPTHAMOLOGIST WAS PERFORMED. A SELLAR/SUPRASELLAR MASS CONSISTENT WITH CRANIOPHARYNGIOMA WAS DISCOVERED. IT WAS CLASSIFIED AS NON-AGGRESSIVE NEOPLASM. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| NO MISDIAGNOSIS | |||||
| Principal Injury Giving Rise To The Claim | |||||
| ALLEGE FAILURE TO PROPERLY/TIMELY DIAGNOSE A BRAIN TUMOR IN A CHILD | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/15/2014 | 2014012774ca01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 7/27/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| ACCESS MEDICAL GROUP OF FLORIDA BALLEN, ANN E SEGAL, ALAN J | |||||
| 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 | |||||
| 4/8/2015 | |||||
| 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 | $68,657 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $3,928 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $2,500 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| NONE | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201575402 |
| Claim Number : | 59205301 |
| Date Submitted : | 7/31/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PHYSICIANS INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 13-4235490 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Antrine | Long | |||
| Street Address | |||||
| 361 Hillsboro Blvd. | |||||
| City | State | Zip | |||
| Deerfield Beach | FL | 33441 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 788 - 5184 | (954) 944 - 1382 | along@picinsurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Liuska | Mariscal | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 751 Palm Drive | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33157 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 139364 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME95687 | Pediatrics - 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 Hospital/Institution | Non applicable | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | non applicable | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/20/2012 | 12/13/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| THE INSURED SAW THE PATIENT DUE TO A LAZY EYE | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| PATIENT WAS SEEN BY THE PATIENT DUE TO A LAZY EYE. THEINSURED REFERRED THE PATIENT TO AN OPTHALMOLOGIST. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| PATIENT WAS SEEN BY THE PATIENT DUE TO A LAZY EYE. THEINSURED REFERRED THE PATIENT TO AN OPTHALMOLOGIST. THECODEFENDANT ORDERED AN MRI. THE MRI SHOWED A BRAINTUMOR, BUT THE RESULTS WERE SENT TO THE INCORRECTFACILITY AND THE PATIENT WAS NOT INFORMED OF THEFINDINGS FOR OVER A YEAR. | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/19/2014 | 14-012774 CA 01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 6/8/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Access Medical Group of FLorida Community Medical Group Ballen, M.D., Ann Segal, M.D., James MedEye Associates | |||||
| 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 | |||||
| 6/11/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $21,880 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $126 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Revamp in follow up procedures for labs and tests run outside the insured's office. | |||||||||||||||||||||
| 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. LIUSKA MARISCAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. LIUSKA MARISCAL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).