Department File Number : | M201782531 |
Claim Number : | 22993-01 |
Date Submitted : | 7/11/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PODIATRY INSURANCE COMPANY OF AMERICA | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1403235 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Karen | Kessler | |||
Street Address | |||||
3000 Meridian Blvd., Suite 400 | |||||
City | State | Zip | |||
Franklin | TN | 37067 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 371 - 8776 | 2249 | kkessler@picagroup.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | RANDI | MARGOLIS | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3770 Riverside Way | ||||
City | State | Zip Code | County | ||
Delray Beach | FL | 33445 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1PD0050017 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Podiatric Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PO3282 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | St. Lucie | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Patient's Home | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Patient's home | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/7/2015 | 12/13/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Mycotic right hallux; 3rd, left toe with subungual hematoma with disruption of the nail | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Nail avulsion, right hallux and left, 3rd toe with topical anesthetic and dressing instructions | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
One week later, it appeared that the wounds were fine, but there was an ecchymotic appearance to the dorsum of the foot. The patient went to the emergency room and was hospitalized, and apparently ultimately died secondary to infection. No further details are available. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 6/22/2017 | ||||
Other Defendants Involved in this Claim | |||||
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 | $6,132 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,284 | ||||||||||||||||||||
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 | |||||||||||||||||||||
None - Specialty code #80993 |
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. RANDI MARGOLIS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RANDI MARGOLIS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).