Department File Number : | M201989098 |
Claim Number : | 163576 |
Date Submitted : | 4/14/2020 |
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 | |||||
2515 PARK PLAZA, BLDG 2-3E | |||||
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 | CHESLOVAS | ROTHSCHILD | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1887 KINGSLEY AVE STE 1900 | ||||
City | State | Zip Code | County | ||
ORANGE PARK | FL | 32073 | Clay | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10116 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79921 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Clay | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
ORANGE PARK MEDICAL CENTER | 100226 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/4/2016 | 12/27/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
WORSENING NUMBNESS IN RIGHT LEG, ABDOMINAL CRAMPING AFTER VERTEBRAL MANIPULATIONS AT URGENT CARE CLINIC. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EVALUATED, DIAGNOSED WITH DEGENERATIVE DISC DISEASE. MRI ORDERED. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
CORD COMPRESSION. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/26/2018 | 2018-CA-002667 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 5/23/2019 | ||||
Other Defendants Involved in this Claim | |||||
BARCLAY-SHELL, M.D., FAYE BROWN, N.C.M.A., JAIDEL ERGENT CARE | |||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
5/21/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $54,814 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $33,658 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $30,000 | ||||||||||||||||||||
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 : | M201989958 |
Claim Number : | 158728-2 |
Date Submitted : | 9/13/2019 |
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 | CHESLOVAS | ROTHSCHILD | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1887 KINGSLEY AVE STE 1900 | ||||
City | State | Zip Code | County | ||
ORANGE PARK | FL | 32073 | Clay | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10114 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME79921 | Neurology - Including Child - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Clay | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
ORANGE PARK MEDICAL CENTER | 100226 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | EMERGENCY ROOM | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/24/2014 | 7/19/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
HEADACHE FIVE DAYS AFTER ENDOSCOPIC ETHMOIDECTOMY AND BILATERA MAXILLARY ANTROSCOPY. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EVALUATED AND DISCHARGED. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
FAILURE TO DIAGNOSE CSF LEAKS. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/17/2016 | 2016-CA-001146 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Clay | 8/21/2019 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
8/16/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $12,450 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $21,490 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $17,897 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $5,000 | ||||||||||||||||||||
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. |
Does Dr. CHESLOVAS ROTHSCHILD, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CHESLOVAS ROTHSCHILD, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).