Department File Number : | M201990844 |
Claim Number : | 386437 |
Date Submitted : | 12/12/2019 |
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 | Angela | LaFrance | |||
Street Address | |||||
12724 Gran Bay Pkwy., W., Suite 400 | |||||
City | State | Zip | |||
JACKSONVILLE | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3045 | (707) 927 - 1809 | alafrance@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Amy | Fox | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2270 Colonial Blvd. | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33907 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1130669 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME105636 | Radiology - therapeutic - minor surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Practioner's office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
3/12/2019 | 6/27/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
This post-op bilateral mastectomies patient was referred to the insured for radiation therapy. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Radiation treatment to left chest wall. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged treatment was done to incorrect side of chest wall. | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged inappropriate treatment to left chest wall resulting in burns and scarring. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/6/2019 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/3/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $62,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $1,500 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral made if appropriate. |
Updates | |
No updates found. |
Does Dr. AMY FOX, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AMY FOX, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).