Department File Number : | M201884300 |
Claim Number : | 1622476 |
Date Submitted : | 2/12/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HALLMARK SPECIALTY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
74-2378996 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Pamela | M | Burke | ||
Street Address | |||||
615 Crescent Executive Ct., Suite 212 | |||||
City | State | Zip | |||
Lake Mary | FL | 32746 | |||
Phone | Ext | Fax | E-Mail Address | ||
(828) 255 - 5171 | (321) 972 - 0122 | pamelaburke@hamlinandburton.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | SAURIN | SHAH | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 13731 Metropolis Avenue | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33912 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FLM900172-01 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME82826 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lee | ||||
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 | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/10/2014 | 2/2/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Initially sought treatment due to persistent cough. Claimant's actual condition was diagnosed as Stage IIIB adenocarcinoma of the lungs. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Chest x-ray | |||||
Diagnostic Code : | 162.9 | ||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None. Dr. Shah interpreted x-rays as showing 2 cm ill-defined density at the left lung apex and recommended Ct of chest if no prior films were available to confirm stability of density. | |||||
Principal Injury Giving Rise To The Claim | |||||
Delayed diagnosis of lung cancer | |||||
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 | ||||
6/23/2016 | 16CA002245 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 12/7/2017 | ||||
Other Defendants Involved in this Claim | |||||
Fort Myers Internal Medicine, LLC Haddad, MD, Robert | |||||
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 | ||||
Other | Order of Dismissal | ||||
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 | $105,378 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $10,000 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
None. Insured made no error, which is why claim was dismissed against insured. |
Updates | |
No updates found. |
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Does Dr. SAURIN SHAH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SAURIN SHAH, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).