| Department File Number : | M202093020 |
| Claim Number : | PPLRRG-JA-16-365150 |
| Date Submitted : | 7/17/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PHYSICIANS PROFESSIONAL LIABILITY RISK RETENTION GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 33-1010508 | |||||
| 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 | JASON | L | ADLER | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3501 JOHNSON STREET | ||||
| City | State | Zip Code | County | ||
| HOLLYWOOD | FL | 33021 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 106655 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME90037 | Pediatrics - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Dade | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Hospital/Institution | JOE DIMAGGIO CHILDREN'S HOSPITAL | ||||
| 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 | ||||
| 8/12/2015 | 9/28/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| MENINGITIS | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| SEEN IN ER | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| NO MISDIAGNOSIS | |||||
| Principal Injury Giving Rise To The Claim | |||||
| DEATH DUE TO MENINGITIS | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 3/27/2017 | CACE17004977 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 7/16/2020 | ||||
| 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 | |||||
| 5/21/2020 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $212,500 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $33,043 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $12,337 | ||||||||||||||||||||
| 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. |
| Department File Number : | M201886762 |
| Claim Number : | PPLRRG-JA-17-380198 |
| Date Submitted : | 10/17/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PHYSICIANS PROFESSIONAL LIABILITY RISK RETENTION GROUP, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 33-1010508 | |||||
| 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 | JASON | L | ADLER | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3501 JOHNSON STREET | ||||
| City | State | Zip Code | County | ||
| HOLLYWOOD | FL | 33021 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 106655 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME90037 | Pediatrics - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Hospital/Institution | JOE DIMAGGIO CHILDREN'S HOSPITAL | ||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/27/2015 | 10/31/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| MRSA | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| MRSA | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| MRSA | |||||
| Principal Injury Giving Rise To The Claim | |||||
| MRSA | |||||
| Severity Of Injury | |||||
| Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 9/11/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| Dropped before Action Filed | |||||
| 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 | $6,300 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1,342 | ||||||||||||||||||||
| 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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. JASON L ADLER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JASON L ADLER, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).