Department File Number : | M201576506 |
Claim Number : | EMC-FL-14-263296 |
Date Submitted : | 12/9/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EmCare Holdings, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
75-173235 | SI | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
9821 Katy Freeway | |||||
City | State | Zip | |||
Houston | TX | 77024 | |||
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 | GERRY | M | VANDER VELDE | ||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 1500 LEE BLVD | ||||
City | State | Zip Code | County | ||
LEHIGH ACRES | FL | 33936 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HAZ1040025381-12 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME115648 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | LEHIGH REGIONAL MEDICAL CENTER | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/15/2013 | 4/7/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
APPENDICITIS | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
TREATED IN ER | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
FAILURE TO DIAGNOSE APPENDICITIS | |||||
Principal Injury Giving Rise To The Claim | |||||
DEATH | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/1/2014 | 14CA001420 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 12/9/2015 | ||||
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 | |||||
No Payment Made | |||||
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 | $53,187 | ||||||||||||||||||||
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 | |
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Does Dr. GERRY M VANDER VELDE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GERRY M VANDER VELDE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).