Department File Number : | M201884699 |
Claim Number : | FP4321201 |
Date Submitted : | 4/3/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
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 | Christine | L | Burns | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 14003 Lakeshore Blvd. | ||||
City | State | Zip Code | County | ||
Hudson | FL | 34667 | Pasco | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-IN007253 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME32382 | Surgery - Opthalmology |
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 | ||||
MEASE HOSITAL - COUNTRYSIDE | 110001 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Nursery | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/30/2010 | 6/7/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Retinopathy of prematurity. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Ophthalmic screening every two weeks for ROP and diagnosis of stage 2 with 2 week followup ordered. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Parents failed to realize the seriousness of condition and failed to keep scheduled follow-up appointment. Child became blind. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/18/2014 | 13-2313-CI-07 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 3/6/2018 | ||||
Other Defendants Involved in this Claim | |||||
Pediatrix Foster, MD, Cherie North Pinellas Childrens Medical Center Razman, MD, Dolores Black, MD, Janet | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After court verdict and prior to filing of notice of appeal. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Judgment for the defendant. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
3/6/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | ||||||||||||||||
Date of Change: | 4/3/2018 2:21:53 PM | |||||||||||||||
Reason for Change: | Correction to injured persons address. | |||||||||||||||
|
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. CHRISTINE L BURNS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CHRISTINE L BURNS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).