Department File Number : | M201990027 |
Claim Number : | 47963 |
Date Submitted : | 9/24/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Lakeland Regional Health | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-265045 | 4413 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Traci | Burchell | |||
Street Address | |||||
1324 Lakeland Hills Blvd | |||||
City | State | Zip | |||
Lakeland | FL | 33804 | |||
Phone | Ext | Fax | E-Mail Address | ||
(863) 687 - 1025 | traci.burchell@mylrh.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Raul | Alvarez | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 430 E Central Ave | ||||
City | State | Zip Code | County | ||
Winter Haven | FL | 33880 | Polk | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
LRMC2018 | $3,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME50256 | Pediatrics - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Polk | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
Lakeland Regional Medical Center | 100157 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/20/2017 | 10/22/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Congenital heart disease | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
misdiagnosis | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
death | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/19/2019 | 2019-CA-002518 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Polk | 9/3/2019 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
9/3/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $350,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $14,484 | ||||||||||||||||||||
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 | |||||||||||||||||||||
providers will refer patients with cardiac symptoms to cardiologist |
Updates | |
No updates found. |
Does Dr. RAUL ALVAREZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RAUL ALVAREZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).