| Department File Number : | M201885598 |
| Claim Number : | 36001404 |
| Date Submitted : | 6/13/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CENTURION MEDICAL LIABILITY PROTECTIVE RISK RETENTION GROUP | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 20-1145017 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Laura | Hall | |||
| Street Address | |||||
| Two Riverway, Suite 900 | |||||
| City | State | Zip | |||
| Houston | TX | 77056 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (713) 353 - 1636 | laura.hall@esis.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Reginald | Pereira | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 242 NW 42nd Ave | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33126 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| FL4704 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME59037 | Emergency Medicine - No Major Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| UNIVERSITY OF MIAMI HOSPITAL AND CLINICS | 100079 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/13/2015 | 11/17/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Presented to ER for kidney stone | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Admitted due to infection and blood in urine. Cardiologist called for short episode of non-sustained ventricular tachycardia while on telemetry monitor. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Failure to recognize a complication. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged discharged patient without providing adequate care for cardiac condition. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 5/15/2018 | ||||
| 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 | |||||
| 5/1/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $60,190 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| None | |||||||||||||||||||||
| 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.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Does Dr. REGINALD PEREIRA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. REGINALD PEREIRA, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).