Department File Number : | M201885102 |
Claim Number : | WC/108888-17 |
Date Submitted : | 4/18/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Watson Clinic LLP | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-070493 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Diane | Szymanski | |||
Street Address | |||||
1600 Lakeland Hills Blvd | |||||
City | State | Zip | |||
Lakeland | FL | 33805 | |||
Phone | Ext | Fax | E-Mail Address | ||
(863) 680 - 7620 | (863) 616 - 2430 | aszymanski@watsonclinic.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Elisabeth | Dupont | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 1600 Lakeland Hills Blvd. | ||||
City | State | Zip Code | County | ||
Lakeland | FL | 33805 | Polk | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PH1605501-PL | $2,000,000 | $18,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME76168 | Surgery - General Practice or Family Practice |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Polk | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Watson Clinic LLP; Women's Center | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Diagnostic Exam Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/22/2016 | 8/29/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was referred to Dr. Dupont's office from an outside provider office for evaluation of a palpable area of concern in the right breast and abnormal finding on a diagnostic mammogram and ultrasound of the right breast. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient was seen, evaluated, and referred to Watson Clinic Women's Imaging by Dr. Dupont's ARNP on 6/17/2016. Dr. Dupont was not involved in the evaluation of this patient until she returned six months later for her follow-up visit in January 2017. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
This case involved a delayed diagnosis of an invasive ductal carcinoma. | |||||
Principal Injury Giving Rise To The Claim | |||||
Unfortunately, when the patient returned six months later, she was diagnosed with an invasive ductal carcinoma. Following an ultrasound-guided aspiration and core biopsy of a mass in her right breast, the patient was diagnosed on 1/6/2017 with lymph node positive triple negative cancer. The patient underwent aggressive treatment, but unfortunately, died on 1/5/2018. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 3/23/2018 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
3/23/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $300,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $19,093 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,782 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Circumstances of event reviewed with individual parties involved. |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
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Does Dr. ELISABETH DUPONT, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ELISABETH DUPONT, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).