| Department File Number : | M201781880 |
| Claim Number : | 2017-08-675-005 |
| Date Submitted : | 4/19/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Lexington Insurace Company | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-114949 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jessica | Hayden | |||
| Street Address | |||||
| 2985 Drew Street | |||||
| City | State | Zip | |||
| Clearwater | FL | 33764 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (727) 519 - 1268 | jessica.hayden@baycare.org | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | MOHAMED SAMY | ELHAMMADY | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 2727 W. Dr. MLK. Jr. Blvd. | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33607 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 120-73-195 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME110382 | Surgery - Neurology - Including Child | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| SAINT JOSEPH'S HOSPITAL | 100075 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/18/2016 | 1/27/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient presented with mass on cervical spine felt to be a large right sided intra & extradural C2 nerve sheath tumor. She had complaints of headache, neck pain and bilateral hand weakness. She was admitted for surgery on 10/18/16. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Resection of large right sided extradural C1-2 nerve sheath tumor. Portion of tumor within the spinal canal approx. 15 mm & extraforaminal component 15 x 20 x 36mm. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Yes. The MD noted at the patient¿s post-op follow up visit that this was 20 year old female, status post resection of a large right sided intra & extradural C2 nerve sheath tumor. ¿Benign neoplasm of peripheral nerves¿. No chemotherapy or radiation therapy was ordered at that time on 10/31/16. Later pathology confirmed C1-2 Lesion Biopsy- Malignant SMARCBI deficient neoplasm, likely falling in the spectrum of adult malignant rhabdoid tumor; C1-2 High Grade Sarcoma. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| On 1/10/17 MRI showed severe mass effect to the cervicomedullary junction and upper cervical cord from the tumor. The patient developed quadriplegia and is vent dependent. Her prognosis is poor and her condition is terminal. Expert review indicates that the patient¿s rhabdoid sarcoma is rare in adults and her life expectancy would be limited to approximately 5 years. | |||||
| Severity Of Injury | |||||
| Permanent: Grave - Quadraplegia, severe brain damage, lifelong care or fatal prognosis. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 3/17/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Settlement Reached Prior to Pre-Suit Period | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 3/17/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $1,400,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $9,433 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Any risk issue have been/will be addressed. | |||||||||||||||||||||
| 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.
| Department File Number : | M201886628 |
| Claim Number : | 2017-08-675-008 |
| Date Submitted : | 10/8/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| LEXINGTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-114949 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kaye | Monello | |||
| Street Address | |||||
| 2985 Drew Street | |||||
| City | State | Zip | |||
| Clearwater | FL | 33759 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (727) 754 - 9268 | (727) 519 - 1276 | kaye.monello@baycare.org | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | MOHAMED SAMY | ELHAMMADY | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 2727 W M L King Boulevard | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33607 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 120-73-195 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME110382 | Surgery - Neurology - Including Child | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| SAINT JOSEPH'S HOSPITAL | 100075 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Special Procedure Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/2/2016 | 3/2/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Bilateral Cerebral Aneurysms | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Insertion of left femoral line | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Retroperitoneal hematoma secondary to puncture site for femoral line being placed too high. | |||||
| 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 | ||||
| 8/18/2017 | 17-CA-007581 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 9/3/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| 9/3/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $51,927 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Any risk issues have been/will be addressed. | |||||||||||||||||||||
| 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. MOHAMED SAMY ELHAMMADY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MOHAMED SAMY ELHAMMADY, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).