| Department File Number : | M201573108 |
| Claim Number : | 318563 |
| Date Submitted : | 1/7/2015 |
| 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 | Tiffany | D | Taylor | ||
| Street Address | |||||
| 13450 West Sunrise Blvd | |||||
| City | State | Zip | |||
| Sunrise | FL | 33323 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (877) 320 - 0748 | TTaylor@thedoctors.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | LUIS | C | REY MARTINEZ | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 2001 West 68th Street | ||||
| City | State | Zip Code | County | ||
| Hialeah | FL | 33016 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0065237 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME71995 | Pathology - Minor 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 | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/17/2011 | 5/20/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient was admitted to Palmetto General Hospital with gross hematuria flank pain and prolonged PTT of 44.5. The patient subsequently died. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Alleged failure to treat the patients condition resulting in her death. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged failure to treat the patients condition resulting in her death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/11/2013 | 13-00967-CA2014 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 12/11/2014 | ||||
| Other Defendants Involved in this Claim | |||||
| Lifemark Hospitals of Florida, Inc. Palmetto General Hospital Roman, M.D., Elroy Elroy Roman, M.D., P.A. Cortes, M.D., Anais B Anais Cortes, M.D., P.A. Contreras, M.D., Jose J Jose J. Contreras, M.D., P.A. Inpatient Healthcare Group, P.I. | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| After court verdict and prior to filing of notice of appeal. | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| Judgment for the plaintiff. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 12/12/2014 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $500,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $12,000 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $250,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Unknown | |||||||||||||||||||||
| 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. LUIS C REY MARTINEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. LUIS C REY MARTINEZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).