Department File Number : | M201679560 |
Claim Number : | 331090 |
Date Submitted : | 8/29/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | BRIAN | P | CORNNELL | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 7090 131st Street North | ||||
City | State | Zip Code | County | ||
Seminole | FL | 33776 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0352180 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME42908 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
PALMS OF PASADENA HOSPITAL | 100126 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/17/2013 | 6/18/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to the hospital with abdominal pain following bariatric surgery. The patient has a colostomy. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insured interpreted CT Scan. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to identify a ruptured viscous resulting in a colostomy. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/21/2015 | 15-003515-CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 8/1/2016 | ||||
Other Defendants Involved in this Claim | |||||
Rehnke, MD, Ernest Ernest Rehnke, MA PA Palms of Pasadena Hospital McCartan, DO, James A Pasadena Center for Asthma & Lung Disorders | |||||
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 | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Other | Dismissed | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/1/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $127,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $28,614 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $12,779 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $127,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
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.
Department File Number : | M201679909 |
Claim Number : | 313273 |
Date Submitted : | 10/26/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Brian | Cornnell | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1501 Pasadena Avenue South | ||||
City | State | Zip Code | County | ||
South Pasadena | FL | 33707 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
352180 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME42908 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
PALMS OF PASADENA HOSPITAL | 100126 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/22/2011 | 12/13/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented to his PCP for persistent cough and respiratory symptoms. The PCP ordered a chest x-ray. The patient was ultimately diagnosed with metastatic lung cancer. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insured interpreted a chest x-ray. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to appreciate the asymmetric nodular density on a chest x-ray and failure to recommend a CT resulting in a delay to diagnose lung cancer. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/20/2014 | 14-002581-CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 9/26/2016 | ||||
Other Defendants Involved in this Claim | |||||
Palms of Pasadena Hospital Labrador, Carlos | |||||
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 | ||||
Other | Dismissed | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
9/26/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $24,731 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $29,309 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |||||||||||||||||||||||||||||||||||||
Date of Change: | 10/26/2016 11:27:33 AM | ||||||||||||||||||||||||||||||||||||
Reason for Change: | Incorrect claim information previously entered. | ||||||||||||||||||||||||||||||||||||
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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. BRIAN P CORNNELL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BRIAN P CORNNELL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).