| Department File Number : | M201987584 |
| Claim Number : | SM400448 |
| Date Submitted : | 1/11/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| EVANSTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-2950161 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | CRYSTAL | L | ALSTON-BAYTON | ||
| Street Address | |||||
| 4600 COX ROAD | |||||
| City | State | Zip | |||
| GLEN ALLEN | VA | 23060 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (804) 864 - 3731 | (855) 662 - 7535 | CALSTONBAYTON@MARKELCORP.COM | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | CYNTHIA | D | MCDONALD | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 6841 45TH ST | ||||
| City | State | Zip Code | County | ||
| LAUDERHILL | FL | 33319 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| SM910916 | $1,000,000 | $5,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Other | MEDICAL DENTAL BEHAVIOR HEALTH | ||||
| License Number | Specialty Code & Classification | Certification Number | |||
| RN9305620 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Prison | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | INFIRMARY | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/7/2016 | 4/7/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| PERITONITIS | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| FAILURE TO DIAGNOSIS PERITONITIS | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| DEATH CAUSED BY PERITONITIS SECONDARY TO A RUPTURED DIVERTICULUM | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 10/26/2017 | 017CV62007DPG | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 5/31/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $3,000,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $12,708 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| NONE | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. CYNTHIA D MCDONALD, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CYNTHIA D MCDONALD, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).