Department File Number : | M201783240 |
Claim Number : | CORP-11-165742 |
Date Submitted : | 10/3/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
TEAM HEALTH, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
62-1562558 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
1900 W. LOOP S., STE. 1500 | |||||
City | State | Zip | |||
Houston | TX | 77027 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DEREK | HOFFERT | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 119 OAKFIELD DRIVE | ||||
City | State | Zip Code | County | ||
BRANDON | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
6796968 | $750,000 | $100,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | NURSE PRACTITIONER | ||||
License Number | Specialty Code & Classification | Certification Number | |||
ARNP9275014 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
BRADFORD HOSPITAL | 100103 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/21/2009 | 12/5/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PANUSINUSTITIS AND PERIORBITAL CELLULITIS | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
SEEN IN ER | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
FAILURE TO DIAGNOSE | |||||
Principal Injury Giving Rise To The Claim | |||||
BRAIN ABSCESSES, BLINDNESS AND HEMIPARESIS | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/26/2012 | 12004960 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 10/3/2017 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
9/11/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $750,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
UNKNOWN |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201782799 |
Claim Number : | 107-008296 |
Date Submitted : | 8/11/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LEXINGTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-1149494 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | carolyn | r | ewell | ||
Street Address | |||||
17200 W 119th St | |||||
City | State | Zip | |||
Olathe | KS | 66061 | |||
Phone | Ext | Fax | E-Mail Address | ||
(913) 495 - 4217 | carolynranee.ewell@aig.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Derek | K | Hoffert | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 119 Oakfield Dr | ||||
City | State | Zip Code | County | ||
Brandon | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
6796968 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Registered Nurse | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ARNP9275014 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
BRANDON REGIONAL HOSPITAL | 100243 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/21/2009 | 12/5/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
NOTICE OF INCIDENT REGARDING FAILURE TO DIAGNOSE PANUSINUSITIS, PERIORBITAL CELLULITIS RESULTING IN BRAIN ABSCESSES 2 MONTHS LATER, BLINDNESS, HEMIPARESIS IN MINOR CHILD. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Diagnosed a single contusion with soft tissue hematoma to the face, blepharitis, left eye, and acute sinusitis, and discharged plaintiff home | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Plaintiff was never seen nor evaluated by the emergency room physician. | |||||
Principal Injury Giving Rise To The Claim | |||||
failure to diagnose panusinusitis, resulted in brain abscesses & hemiparesis in 11 year old female. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/28/2012 | 12 004960 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 7/26/2017 | ||||
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 | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $21,242 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. DEREK HOFFERT, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DEREK HOFFERT, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).