| Department File Number : | M201781116 |
| Claim Number : | 157238-2 |
| Date Submitted : | 12/21/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTH CARE INDEMNITY, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 61-0904881 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Teresa | Ross | |||
| Street Address | |||||
| One Park Plaza P.O. Box 555 | |||||
| City | State | Zip | |||
| Nashville | TN | 37202 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Michelle | Allin | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 7201 N University Drive | ||||
| City | State | Zip Code | County | ||
| Tamarac | FL | 33321 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HCI-10113 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Other | Nurse Practitioner | ||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ARNP1983642 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| UNIVERSITY HOSPITAL AND MEDICAL CTR.(TAMARAC) | 100224 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Emergency Room | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/24/2013 | 1/26/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Epidural abscess. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Allege a more through history should have been obtained & a more through physical exam/assessment/reassessment should have been performed which would have resulted in a STAT MRI. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Patient presented with complaints of sudden weakness with right & left flank pain radiating to back & urine infection. Nursing notes reflect that patient unable to bear weight on both legs & ER physician made aware. Following day MRI performed which revealed epidural abscess. Patient underwent T5-6 laminectomy for evacuation of abscess. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Paraplegia. | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/27/2016 | 062016CA009507 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 1/25/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Haffizula, M.D., Jason Liska, PA-C, Karina Medical Associates of Tamarac, P.A. | |||||
| 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 | |||||
| 1/23/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $900,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $26,896 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $22,014 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $535,675 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Review of policies and procedures. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 12/21/2017 1:22:03 PM | |||||||||
| Reason for Change: | Additional LAE payments made. | |||||||||
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Does Dr. MICHELLE ALLIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MICHELLE ALLIN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).