Department File Number : | M201678626 |
Claim Number : | SAM-IG-005463 |
Date Submitted : | 6/5/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3433505 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | NANCY | CARR | |||
Street Address | |||||
11440 SW 88th STREET | |||||
City | State | Zip | |||
MIAMI | FL | 33176 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | OTTO | VEGA | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 975 Baptist Way | ||||
City | State | Zip Code | County | ||
Homestead | FL | 33030 | Monroe | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SPL 1060 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME86878 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Monroe | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HOMESTEAD HOSPITAL (DADE) | 100125 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/21/2010 | 6/13/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right lateral malleolus fracture and fractures of the posterior and lateral malleoli. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
There was no operation, diagnostic or treatment procedure causing the injury. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis of this patient. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient was seen in the ED for diagnosis of a left ankle fracture. The patient was stabilized and referred to her podiatrist for further treatment on an outpatient basis. The plaintiff's attorney alleged a failure to properly treat resulting in displaced bimalleolar fractures. This allegation was never substantiated by an expert and this lawsuit was voluntarily dismissed against this practitioner. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/23/2012 | 12-41100 CA 31 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 3/28/2014 | ||||
Other Defendants Involved in this Claim | |||||
Maederer, Mark Gershben, Darryl Frias, Juan Marin, Edgar HomesteadMed, PA Homestead Hospital Mark Maederer, JR, DPM, Inc Miami Foot Center | |||||
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 | $36,268 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $8,084 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not applicable. |
Updates | |
No updates found. |
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Does Dr. OTTO VEGA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. OTTO VEGA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).