Department File Number : | M201988384 |
Claim Number : | 1036731-04 |
Date Submitted : | 9/25/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-6021331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Michelle | Pierron | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(800) 463 - 3776 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Donald | W | Durrance | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 6150 Ivy Hill Ln | ||||
City | State | Zip Code | County | ||
Brooksville | FL | 34602 | Hernando | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HN006099 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME49786 | Radiology - Diagnostic - Minor 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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BAYFRONT MEDICAL CENTER | 100032 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/5/2014 | 9/8/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Severe headache, nausea, vomiting | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Read of a CT scan of the head and a CT of the brain | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to diagnose aneurysm | |||||
Principal Injury Giving Rise To The Claim | |||||
Death from brain bleed | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/25/2017 | 2017-CA-000770 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 3/6/2019 | ||||
Other Defendants Involved in this Claim | |||||
Mazzaferro, Michael FC Emergency Phsyicians LLC Florida EM-I Medical Services PA Hernando HMA, LLC | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
3/5/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $650,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $20,915 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $650,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
NA |
Updates | |
No updates found. |
Does Dr. DONALD W DURRANCE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DONALD W DURRANCE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).