Department File Number : | M201677643 |
Claim Number : | MM262178 |
Date Submitted : | 3/21/2016 |
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 | OMID | J | HOZUMI | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 909 KAPIOLANI BLVD; #3401 | ||||
City | State | Zip Code | County | ||
HONOLULU | HI | 96814 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MM821055 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME102227 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
PARRISH MEDICAL CENTER | 100028 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Labor and Delivery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/26/2009 | 1/24/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
18 Y/O CLAIMANT CAME FOR DELIVERY OF CHILD ON OCTOBER 26, 2009 AND SOUGHT EPIDURAL. THE EPIDURAL WAS ADMINISTERED BY THE INSD RADIOLOGIST, DR OMID J HOZUMI. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
ON OCTOBER 26, 2009, DR. OMID J HOZUMI ADMINISTERED AN EPIDURAL TO 18 Y/O CLAIMANT WHILE IN LABOR IN DELIVERY FOR PAIN CONTROL. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
THERE WAS NO MISDIAGNOSIS. | |||||
Principal Injury Giving Rise To The Claim | |||||
EPIDURAL ADMINISTERED BY RADIOLOGIST OMID J HOZUMI, MD TO 18 Y.O CLMT DURING OCTOBER 26, 2009 DELIVER. FOLLOWING DISCHARGE, CLMT RETURNED ON OCTOBER 29, 2009 FOR HEADACHES AND NAUSEA AND UNDERWENT BLOOD PATCH ON OCTOBER 30 OR OCTOBER 31, 2009. CLAIMANT THEN SUFFERED SEIZURE ON DECEMBER 11, 2009 AND UNDERWENT SURGERIES TO DRAIN SUBDURAL HEMATOMA AND PLACE STENT. | |||||
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 | ||||
5/25/2012 | 05-2012-CA-045239 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 7/20/2015 | ||||
Other Defendants Involved in this Claim | |||||
VISTA STAFFING SOLUTIONS, INC. | |||||
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 | ||||
Other | DISMISSED WITHOUT PREJUDICE | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
7/16/2015 |
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 | $65,070 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $65,070 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
NONE |
Updates | |
No updates found. |
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Does Dr. OMID J HOZUMI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. OMID J HOZUMI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).