Department File Number : | M201574570 |
Claim Number : | 9941.179 |
Date Submitted : | 5/8/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6599936 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | L | Wallace | ||
Street Address | |||||
341 3rd Street S | |||||
City | State | Zip | |||
St. Petersburg | FL | 33701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | SALEEM | KHAMISANI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1201 5TH AVENUE N | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33705 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
49210-13 | $1,000,000 | $2,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME83502 | Psychiatry - All Other |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | St. Anthony's Neurology Group | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/11/2012 | 2/28/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
In dispute, possibly aneurysm and possibly other conditions. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
None. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
In dispute. Patient claims an aneurysm caused symptoms and there was medical evidence to refute that. | |||||
Principal Injury Giving Rise To The Claim | |||||
Ruptured aneurysm. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/24/2013 | 13-007476-CI-19 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 4/20/2015 | ||||
Other Defendants Involved in this Claim | |||||
St. Anthony's Specialists d/b/a St. Anthony's Neuro. Group | |||||
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 | |||||
4/20/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $650,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $15,096 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Based on positive physician and expert review, none deemed necessary. |
Updates | |
No updates found. |
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Department File Number : | M201783228 |
Claim Number : | 15003/11944 |
Date Submitted : | 9/29/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6599936 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | L | Wallace | ||
Street Address | |||||
341 3rd Street S | |||||
City | State | Zip | |||
St. Petersburg | FL | 33701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Saleem | R | Khamisani | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1201 5th Avenue North, Suite 202 | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33705 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
49210-15 | $1,000,000 | $2,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME83502 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT ANTHONY'S HOSPITAL | 100067 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/8/2013 | 7/1/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Stroke like symptoms, seizure activity | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No operation or diagnostic treatment caused the injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
After being discharged on seizure medication, patient continued to have seizures and was hospitalized with possible ADEMs | |||||
Principal Injury Giving Rise To The Claim | |||||
Ongoing seizure activity despite medication | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/31/2015 | 008228-CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 8/18/2017 | ||||
Other Defendants Involved in this Claim | |||||
Franklin, Michael A Kevill, John A St. Anthony's Hospital, 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 | ||||
Other | Settled through mediation | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
9/25/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $80,431 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $21,958 | ||||||||||||||||||||
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, doctor did not deviate from standard of care |
Updates | |
No updates found. |
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Does Dr. SALEEM KHAMISANI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SALEEM KHAMISANI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).