Department File Number : | M201576646 |
Claim Number : | 1425297 (Cheong, MD) |
Date Submitted : | 12/21/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
H. Lee Moffitt Cancer Center & Research Institute, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
3238634 | 4334 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Brenda | C | Warren | ||
Street Address | |||||
17107 Longacres Lane | |||||
City | State | Zip | |||
Odessa | FL | 33556 | |||
Phone | Ext | Fax | E-Mail Address | ||
(813) 792 - 1588 | (321) 972 - 0122 | brendawarren@hamlinandburton.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | David | Cheong | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 12902 Magnolia Drive | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33612 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PFP_1000044_P-7 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME87819 | Surgery - oncology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
H. LEE MOFFITT CANCER AND RESRCH. INST. | 110009 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/11/2013 | 10/22/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Osteosarcoma of the left proximal tibia in a 13 year old male. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Osteosarcoma with left proximal tibia replacement and total knee arthroplasty and rotational muscle flap with extension. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
No misdiagnosis made. | |||||
Principal Injury Giving Rise To The Claim | |||||
Excessive external rotation of the left foot due to positioning of tibial;knee prosthesis. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/22/2014 | 111111 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Highlands | 12/10/2015 | ||||
Other Defendants Involved in this Claim | |||||
H. Lee Moffitt Cancer Center & Research Institute, Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $44,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
A computer program to assist surgeons in alignment of prosthetics in this procedure is under development. At this time, there is no objective means of positioning prosthetic hardware. |
Updates | |
No updates found. |
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