Department File Number : | M201783478 |
Claim Number : | 1031094-06 |
Date Submitted : | 8/23/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Cheryl | Johnson | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 19531 Cochran Blvd | ||||
City | State | Zip Code | County | ||
Port Charlotte | FL | 33948 | Charlotte | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
770192 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Physician Assistant | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9104060 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Charlotte | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
FAWCETT MEMORIAL HOSPITAL | 100236 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/12/2014 | 1/29/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Arthritis left knee | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Monitoring of patient post total knee arthroplasty | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to monitor | |||||
Principal Injury Giving Rise To The Claim | |||||
Compartment syndrome and alleged permanent neurological deficits | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/23/2016 | 16-00843-CA | ||||
County Suit Filed in | Date of Final Disposition | ||||
Charlotte | 10/18/2017 | ||||
Other Defendants Involved in this Claim | |||||
Constine MD, Ronald M Reiss DO, Jason Connors MD, Nicholas J Advanced Orthopedic Center of Charlotte County PA Millrnnium Physician Group LLC Taylor PA, Meredith Rodriguez MD, Victor Granier MD, Paul Econopouly PA, Craig Hayes MD, Doris A | |||||
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 | $8,446 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,812 | ||||||||||||||||||||
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 | |||||||||||||||||||||
n/a |
Updates | ||||||||||
Date of Change: | 2/9/2018 2:19:18 PM | |||||||||
Reason for Change: | ALE UPDATE 2/9/2018 | |||||||||
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Date of Change: | 8/23/2018 3:53:40 PM | |||||||||
Reason for Change: | ALE UPDATE | |||||||||
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Does Dr. CHERYL JOHNSON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CHERYL JOHNSON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).