Department File Number : | M201886522 |
Claim Number : | 194902 |
Date Submitted : | 9/24/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE INDEMNITY COMPANY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
63-0720042 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | Stokes | |||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | WILLIAM | MAYORAL | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1817 N Mill Avenue | ||||
City | State | Zip Code | County | ||
Orlando | FL | 32803 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP47982 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME85760 | Internal Medicine - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
ORLANDO REGIONAL MEDICAL CENTER | 100006 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/24/2011 | 5/6/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
79 YOWF admitted for T-8 spinal fracture following MVA expired 10 wks later from multi-organ failure allegedly due to improper treatment & excessive medication. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Complications from medicines that allegedly caused multi-organ failure. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Multi organ failure due to medication given to treat spinal fracture. | |||||
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 | ||||
5/2/2014 | 2014-CA-339-O | ||||
County Suit Filed in | Date of Final Disposition | ||||
Orange | 9/7/2018 | ||||
Other Defendants Involved in this Claim | |||||
Cheatham, Michael l Farooq, Osman Elms, Luke Dumas, Amy Alban, Rodrigo F Fiscina, Creighton Abbott, Lionel C Standifer II, Jesse I Cutshaw, Aaron Q Bada, Alvaro R Smith, Chadwick P Cheesebrew II, John I Mayoral, William Maldonado, Arturo Araujo, Gerson Noon, Shahrbanoo Orlando Regional Medical Center Painter, Thomas Lube, Matthew W Razack, Nizam Quijada, Patricio Promes, John T Golbach, Michael Adigweme, Obinna Short, Chad | |||||
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 | |||||
Dropped before Action Filed | |||||
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 | $5,455 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $117 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discuseed case with defense counsel, insurance personnel, and medical experts. |
Updates | ||||||||||
Date of Change: | 9/24/2018 12:44:54 PM | |||||||||
Reason for Change: | Updated ALAE information | |||||||||
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Does Dr. WILLIAM MAYORAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. WILLIAM MAYORAL, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).