Department File Number : | M201887099 |
Claim Number : | 2010-09-401-019 |
Date Submitted : | 11/20/2018 |
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 | Raul | Jimenez | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 14100 Fivay Road Ste 310 | ||||
City | State | Zip Code | County | ||
Hudson | FL | 34667 | Pasco | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
839-6469 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62750 | Cardiovascular Disease - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pasco | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
COLUMBIA REGIONAL MEDICAL CENTER BAYONET POINT | 100256 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/1/2010 | 9/1/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
55 yo who presented to the ED with atrial fibrillation. He later developed arrhythmia after ablation. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Ablation. Amiodarone was ordered. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
It was alleged that discharge instructions to stop the amiodarone were not clear and the patient remained on the drug too long and developed pulmonary issues. The matter was dismissed and no payment was made on behalf of the MD. This matter is being reported as legal expenses were greater than $5,000. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/17/2011 | 51-2010-CA-7126-WS | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pasco | 1/21/2016 | ||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Summary judgment for the defendant. | |||||
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 | $77,077 | ||||||||||||||||||||
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 were addressed. |
Updates | |
No updates found. |
Department File Number : | M201987532 |
Claim Number : | 1510170103719.00 |
Date Submitted : | 1/8/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PREFERRED PROFESSIONAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-0580977 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teri | Zealand | |||
Street Address | |||||
11605 Miracle Hills Dr Ste 200 | |||||
City | State | Zip | |||
Omaha | NE | 68154 | |||
Phone | Ext | Fax | E-Mail Address | ||
(402) 965 - 3224 | tzealand@coverys.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Raul | A | Jimenez | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 14100 Fivay Rd, Ste 370 | ||||
City | State | Zip Code | County | ||
Hudson | FL | 34667 | Pasco | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SMP0042882 | $250,000 | $750 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME62750 | Cardiovascular Disease - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pasco | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BAYONET POINT SURGERY & ENDOSCOPY CENTER | 14960565 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/8/2015 | 11/9/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
patient passed out in mvaan electrical study of heart was done | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
alleged unnecessary pacemaker installed | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
unnecessary pacemaker | |||||
Principal Injury Giving Rise To The Claim | |||||
the study of the heart electrical report | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 1/7/2019 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
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 | $27,432 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,921 | ||||||||||||||||||||
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 | |||||||||||||||||||||
better reading of electrical tests |
Updates | |
No updates found. |
Does Dr. RAUL JIMENEZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RAUL JIMENEZ, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).