New Mexico: Malpractice Payment of $795,000 for Death of a Male Patient in his 60s (2018)

In 2018, a medical malpractice insurance company made a payment on behalf of a physician (MD) in New Mexico for approximately* $795,000. Payment was made in response to a claim of medical malpractice claim involving the death of a male patient between 60 and 70 years old. The nature of the claim is broadly described as: "monitoring related." The payment report submitted by a medical malpractice payer described the allegations in the claim as "Delay in Diagnosis."

* The payment amount is approximate because the National Practitioner Data Bank codes payments as a range value. The report's description of $795,000 corresponds to a malpractice payment somewhere between $790,001 and $800,000.

Claim at a Glance

Year of Payment: 2018

Location: New Mexico

Allegation: Delay in Diagnosis

Act or Omission: 2016

Payment Range: Between $790,001 and $800,000

Nature of Claim: Monitoring Related

Payer: Insurance Company - Primary Coverage

Type of Care: Outpatient

Reporter: A Medical Malpractice Payer

Claim Insights

With respect to any medical malpractice payment, there are three major components of any claim. First, there is the act or omission that gave rise to an injury and whether the provider departed from an accepted standard of practice. Second, there is the nature of the injury itself, which includes several factors like its severity, duration, the impact on the patient’s life, the age and general health of the patient, along with many other elements. Third, there needs to be a causal connection between the negligent act or omission by the provider and the injury itself. Even with a showing of negligence, a medical provider is not legally responsible for an outcome that was not caused by the negligence.

With this in mind, the Data Bank does have some information that can give context to the medical malpractice payments, including the patient’s age, gender, whether it was inpatient or outpatient care, the type of malpractice or medical mistake that was alleged, and the ultimate outcome to the patient.

The information has significant limitations, however, that everyone should keep in mind. For one thing, the information is usually self-reported by the healthcare provider and his or her representatives. When reviewing this information, you should consider whether the patient would have described his or her injury as “minor” or “temporary” or “emotional only.” Further, there are important aspects of any claim valuation that simply cannot work in a database. Flagrant negligence might be coded the same way as what could be described as a smaller error, and one would have no way of knowing from these data. But even with these limitations and even where some required information is missing from any particular report, each of the payment reports in the database have enough to provide some insightful information that can help evaluate medical malpractice claims going forward.

Provider History Includes Six Licensure Reports

A medical provider's malpractice history can be extremely insightful. A long history of malpractice claims and discipline can certainly affect whether a matter is resolved and for how much. One of the most important goals of the National Practitioner Data Bank is to track providers' disciplinary and malpractice payment history throughout interstate moves or new employment situations.

In addition to this particular malpractice payment, this provider has three other types of reports on record that are worth noting. First, this provider has a total of eight malpractice payments in the database. This is a highly concerning number of medical malpractice payments. To put this number in perspective, throughout over 200,000 payment records, approximately 55% of them are associated with providers with multiple payments. This provider's total of eight malpractice payments is more than 98% of all providers in the database, which is limited to providers with malpractice payment history.

Second, the database reflects that this particular provider had six licensure report(s) on record. These are more unusual among the providers for whom malpractice payments are recorded in the database - only about 15% of the providers with malpractice payments also have at least one licensure report as well.

Third, this provider has a DEA report on record. There are a number of reasons why the DEA would take action against a provider, including prescription practices or requiring oversight with controlled substances. There are only 69 payment reports (.03%) in the entire database associated with any provider with even one such report on record.

Provider Detail

Alerts 15

New Mexico

Physician (MD)

Age: Between 70 and 80 Years Old in 2016 When Allegations Arose

Education Completed: Between 1960 and 1970

Malpractice Payments 8
There are other payments in the database associated with this provider:
YearStateAmountAllegation
2009New Mexico$195,000Failure to Diagnose
2009New Mexico$395,000Failure to Diagnose
2018New Mexico$795,000Delay in Diagnosis
2018New Mexico$485,000Failure to Perform Procedure
2018New Mexico$995,000Failure to Treat
2019New Mexico$445,000Failure to Order Appropriate Medication
2019New Mexico$495,000Wrong or Misdiagnosis
2021New Mexico$145,000Unnecessary Procedure
Licensure Reports 6
Adverse actions by the state licensing board are reported to the NPDB. Some of these actions are public, but some are not. All adverse actions must be reported in this database, whether or not they are public.
DEA Reports 1
These reports are submitted when the Drug Enforcement Administration takes action based on controlled substance registration.
Payments

Similar Claims

Here are other claims involving an allegation of Delay in Diagnosis and an outcome of the death of a patient between 60 and 70 years old.
YearStateAmountAllegation
2024New York$62,500Delay in Diagnosis
2024New Jersey$565,000Delay in Diagnosis
2024New York$295,000Delay in Diagnosis
2024New York$195,000Delay in Diagnosis
2024Texas$595,000Delay in Diagnosis
2024New Jersey$345,000Delay in Diagnosis
2024Illinois$995,000Delay in Diagnosis
2024Illinois$495,000Delay in Diagnosis
2024New Mexico$995,000Delay in Diagnosis
2024Michigan$415,000Delay in Diagnosis