PLCR

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Department File Number : M202299542
Claim Number : 4120210120002
Date Submitted : 11/2/2022
 
Insurer Information
 
Insurer Name Coverage Type
ASPEN AMERICAN INSURANCE COMPANY Primary
Insurer FEIN Professional License Number
75-2344200  
Insurer Contact Information
Type First Name MI Last Name
Individual Elizabeth D Lyman
Street Address
655 North Franklin Street, Ste 1900
City State Zip
Tampa FL 33602
Phone Ext Fax E-Mail Address
(813) 222 - 4176     elyman@bbprograms.com
 
Insured Information
 
Type First Name MI Last Name
Individual Algird   Mameniskis
Insurer Type Street Address of Practice
Licensed 8700 W Flagler St #250
City State Zip Code County
Miami FL 33174 Dade
Policy Number Per Claim Policy Limits Aggregate Policy Limits
PPPAAIC01324220 $250,000 $750,000
Profession or Business Other Profession or Business
Medical Doctor  
License Number Specialty Code & Classification Certification Number
ME137706 Surgery - Plastic  

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report


 
 
Injured Person Information
 
First Name MI Last Name Date of Birth
       
Street Address Gender County where Injury Occurred
  F Dade
City State Zip Code
     
Location where injury occured Other location where injury occured
Other Outpatient Facility Avana Plastic Surgery
Name of Institution Code
N/A 000000
Location of Institutional Injury Other Location of Institutional Injury
Operating Suite  
Date of Occurrence Date Reported to Insurer
6/25/2020 1/20/2021
 
Diagnostic Information
 
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Patient sought insured's care for several elective cosmetic procedures.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Insured performed abdominoplasty, liposuction, and Brazilian Butt-Lift procedures on 06/25/2020. Patient attended two post surgery follow up visits on 06/26/2020 and 07/06/2020 and was cleared to fly back home on 07/06/2020.
Diagnostic Code :  
Misdiagnosis Made, If Any, Of Patient's Actual Condition
*NR
Principal Injury Giving Rise To The Claim
Patient presented to her primary care physician on 07/07/2020 and was taken to hospital following collapse. Emergency department diagnosed patient with septic shock relating to left buttock abscess and patient tested positive for Covid-19. Patient underwent surgery for incision and drainage of abscess and abscess was cultured to be positive for staphylococcus. Patient continued to decline and died on 7/25/2020.
Severity Of Injury
Permanent: Death.

Florida Office of Insurance Regulation
Medical Malpractice Closed Claims Report

 
Legal Information
 
Date of Suit Circuit Court Case Number
10/13/2021 2021023071CA01
County Suit Filed in Date of Final Disposition
Dade 5/2/2022
Other Defendants Involved in this Claim
Silveira, Roxana
Rainbow Recovery, 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
No Court Proceedings.  
Arbitration
Claim not subject to Arbitration.
Date of Payment
5/18/2022
 
Financial Information
 
Was there a settlement Resulting in payment to the Plaintiff? Yes
Indemnity Paid by Insurer on behalf of Insured $250,000
Loss Adjust Expense Paid to Defense Counsel $33,454
All Other Loss Adjustment Expense Paid $752
Injured Person's Total Non-Economic Loss $0
Deductible $0
Injured Person's Total Economic Loss
  Incurred to Date Anticipated
Medical Expense $250,000 $0
Wage Loss $0 $0
Other Expenses $0 $0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
N/A
 
Updates
 
No updates found.

 

 

*NR: Prior to 04/28/1999 this field was not required in submitted claims.

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