| Department File Number : | M201575227 |
| Claim Number : | FL0337 |
| Date Submitted : | 7/17/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 74-3129288 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Yvette | de la Morena | |||
| Street Address | |||||
| 1250 S. Pine Island Road Suite 300 | |||||
| City | State | Zip | |||
| Plantation | FL | 33324 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 923 - 1900 | ymorena@hugroups.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Roberto | Calderon | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12095 SW 49 Street | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33175 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 234-000 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME36177 | Radiology - Diagnostic - Minor 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 | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| WEST KENDALL BAPTIST HOSPITAL | 23960064 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Radiology Dept | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/21/2011 | 12/3/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Treatment was sought for back pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Alleged failure to completely interpret CT of the lumbar spine images which led to abnormality in his abdominal aorta consistent with an abdominal aneurysm | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Abnormality in abdominal aorta consistent with an abdominal aneurysm contributed to death | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/7/2013 | 13-020253 CA 01 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Dade | 5/21/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Kendall Healthcare Group LTD Kendall Regional Radiology Imaging Associates 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 | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 6/25/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $180,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $174,901 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussed with insured | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201576091 |
| Claim Number : | FL0394 |
| Date Submitted : | 10/15/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| HEALTHCARE UNDERWRITERS GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 74-3129288 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Yvette | de la Morena | |||
| Street Address | |||||
| 1250 S. Pine Island Road Suite 300 | |||||
| City | State | Zip | |||
| Plantation | FL | 33324 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (954) 923 - 1900 | ymorena@hugroups.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | ROBERTO | CALDERON | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 12095 SW 49th Street | ||||
| City | State | Zip Code | County | ||
| Miami | FL | 33175 | Dade | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 234-000 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME36177 | Radiology - Diagnostic - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Physicians Office | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 8/15/2012 | 10/1/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Diagnosed with bilateral multifocal astrocytoma Grade III disease | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Estate claims failure to properly interpret MRI of brain | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged failure to interpret MRI of brain | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 10/15/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Roberto Calderon MD PA | |||||
| 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 | $14,779 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussed with insured. | |||||||||||||||||||||
| 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. ROBERTO CALDERON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ROBERTO CALDERON, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).