| Department File Number : | M202091994 |
| Claim Number : | 321541 |
| Date Submitted : | 3/31/2020 |
| 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 | Angela | LaFrance | |||
| Street Address | |||||
| 12724 Gran Bay Pkwy., W., Suite 400 | |||||
| City | State | Zip | |||
| JACKSONVILLE | FL | 32258 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (904) 360 - 3045 | alafrance@thedoctors.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Mohammad | M | Shehadeh | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 209 Berry Farm Lane | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32259 | St. Johns | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0073440 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME109135 | Hospitalists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Clay | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| ORANGE PARK MEDICAL CENTER | 100226 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 5/18/2012 | 8/15/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient presented to the Emergency Department with complaints of severe abdominal pain and nausea. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The insured evaluated the patient and ordered for the Dilaudid dose frequency to be increased for pain control and hold in the event of sedation. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged ordering and administration of Dilaudid. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 2/25/2015 | 2015-CA-000190 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Clay | 3/20/2020 | ||||
| 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 | |||||
| 3/19/2020 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $392,854 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $9,404 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Insurance company staff consulted with insured to discuss preventative measures. Patient safety referral is made if appropriate. | |||||||||||||||||||||
| Updates | |
| No updates found. |
| Department File Number : | M201576103 |
| Claim Number : | 326200 |
| Date Submitted : | 10/16/2015 |
| 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 | AUDRA | M | FLOYD | ||
| Street Address | |||||
| 13450 WEST SUNRISE BLVD | |||||
| City | State | Zip | |||
| SUNRISE | FL | 33323 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (877) 320 - 0748 | 3111 | (866) 636 - 5421 | afloyd@thedoctors.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Mohammad | Shehadeh | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1200 Riverplace Boulevard, Ste. #620 | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32207 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 0073440 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME109135 | Hospitalists | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Duval | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BAPTIST MEDICAL CENTER - BEACHES | 100117 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/11/2012 | 1/15/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient presented to the ER with complaints of abdominal and chest pain. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The insured's only involvement was a telephone order for a CT angio of the patient's chest and ABGs to rule out pulmonary emboli. Notice of Intent was withdrawn. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged failure to treat aortic dissection and ischemic bowel resulting in death. Notice of Intent was withdrawn. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 10/14/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Community Hospice of Northeast Florida Daigle, MD, Andrew Dargon, MD, Doreen Gupta, MD, Anand S Lee, MD, Raymond T Leu, MD, Shannon T Neurology Care Consultants, LLC Baptist Medical Center Jacksonville Cardiothoracic & Vascular Surgical Associates, PA Jacksonville Heart Center, PA Baptist Cardiology, Inc. McCarthy, PA, Carlton Hassel, MD, Carl D Cousar, MD, Charles Utset, MD, Bernard M ABC Answering Services, Inc. Moncrief, Mona Reyes, James | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| No Payment Made | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $24,000 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| 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. MOHAMMAD M SHEHADEH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MOHAMMAD M SHEHADEH, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).