Department File Number : | M201887270 |
Claim Number : | 161864 |
Date Submitted : | 12/12/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christina | J | Stoker | ||
Street Address | |||||
1100 Dr. Martin Luther King Jr. Blvd, Ste. 500 | |||||
City | State | Zip | |||
Nashville | TN | 37203 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 1779 | (866) 715 - 7235 | christina.stoker@hcahealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JENNIFER | L | JONES | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 119 OAKFIELD DRIVE | ||||
City | State | Zip Code | County | ||
BRANDON | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10115 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10641 | Emergency Medicine - No 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 | ||||
Other | EMERGENCY ROOM | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/10/2015 | 5/11/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PRESENTED WITH LOW BACK PAIN, RIGHT LEG NUMBNESS; HISTORY OF PREVIOUS BACK SURGERY. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EVALUATED, PRESCRIBED PAIN MEDS AND TOLD TO FOLLOW UP WITH PERSONAL PHYSICIAN. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
CAUDA EQUINA SYNDROME, MULTIPLE SURGERIES, NEUROGENIC BLADDER. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/14/2017 | 17-CA-8565 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 11/29/2018 | ||||
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 | |||||
10/23/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $400,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
REFERRED TO RISK MANAGEMENT. |
Updates | |
No updates found. |
Department File Number : | M201783011 |
Claim Number : | 160704 |
Date Submitted : | 7/26/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JENNIFER | L | JONES | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 119 OAKFIELD DRIVE | ||||
City | State | Zip Code | County | ||
BRANDON | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10115 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10641 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | 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 | ||||
Other | EMERGENCY ROOM | ||||
Date of Occurrence | Date Reported to Insurer | ||||
11/21/2015 | 2/20/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Stab wound right bicep. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Allege failure to diagnose ulnar nerve injury due to stab wound during two ER visits. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Patient to ER twice with stab wound to back of right arm. Patient was treated & released both occasions. On 2nd visit, claims that he had numbness & tingling in hand & fingers & claimed that it was present day before at earlier visit. Ultimately patient had surgery on right arm to address ulnar nerve injury, which resulted in 2 claw fingers on right hand. | |||||
Principal Injury Giving Rise To The Claim | |||||
Right ulnar nerve damage. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 7/26/2018 | ||||
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 | |||||
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 | $4,475 | ||||||||||||||||||||
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 | |||||||||||||||||||||
REVIEW OF POLICIES AND PROCEDURES. |
Updates | |||||||||||||||||||
Date of Change: | 7/26/2018 1:56:32 PM | ||||||||||||||||||
Reason for Change: | ADDITIONAL LAE PAYMENTS MADE. | ||||||||||||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. JENNIFER L JONES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JENNIFER L JONES, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).