Department File Number : | M201574652 |
Claim Number : | 318410 |
Date Submitted : | 5/18/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tiffany | D | Taylor | ||
Street Address | |||||
13450 West Sunrise Blvd | |||||
City | State | Zip | |||
Sunrise | FL | 33323 | |||
Phone | Ext | Fax | E-Mail Address | ||
(877) 320 - 0748 | TTaylor@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | SHRAVAN | AMBATI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1616 Lake Underhill Road, Suite 215 | ||||
City | State | Zip Code | County | ||
Orlando | FL | 32825 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0070483 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME105350 | Surgery - Cardiovascular Disease |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
FLORIDA HOSPITAL - EAST ORLANDO | 100021 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/16/2013 | 5/15/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
On 7/16/13, this 66 year old male patient presented to the hospital. The insured was called for a consult due to pt's complaints of chest pain and an abnormal ECG. The insd performed an echocardiogram. The pt suffered paraplegia as a result of alleged delay in diagnosis and treatment of thoracic epidural hematoma. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured performed an echocardiogram due to complaints of chest pain. The patient was diagnosed with a spinal hematoma. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to diagnose a spinal hematoma resulting in paraplegia. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/24/2014 | 2014-CA-010036-O | ||||
County Suit Filed in | Date of Final Disposition | ||||
Orange | 4/29/2015 | ||||
Other Defendants Involved in this Claim | |||||
Adventist Health System/ Sunbelt, Inc dba Florida Hosp East Alexis, M.D., Alexandra Zaman, DO, Nikhat Gomez, M.D., Rebecca Ann Marie Hunkar-Huie, ARNP Central Florida Hospitalist Partners, P.A. Orlando Heart and Vascular, LLC | |||||
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 | Dismissed | ||||
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 | $32,010 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
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. SHRAVAN AMBATI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SHRAVAN AMBATI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).