Department File Number : | M201679105 |
Claim Number : | 70686A |
Date Submitted : | 7/15/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | James | P | Lacey | ||
Street Address | |||||
245 Riverside Avenue, Suite 550 | |||||
City | State | Zip | |||
Saint Johns | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(855) 663 - 3625 | 127 | (888) 974 - 6458 | jlacey@medmaldirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christopher | J | Bosarge | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 5149 North 9th Ave, Suite 120 | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 73699 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707264 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME73699 | Radiology - interventional |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SACRED HEART HOSPITAL (PENSACOLA) | 100025 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/14/2016 | 3/23/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Left sided flank pain related to kidney. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Nephrostomy tube placement | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Hospital submitted wrong patient for procedure. | |||||
Principal Injury Giving Rise To The Claim | |||||
Pain and suffering and additional procedure to reverse nephrostomy tube. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 6/28/2016 | ||||
Other Defendants Involved in this Claim | |||||
Sacred Heart Health System, Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
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? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Discussed case with insured and reviewed hospital procedures for time outs |
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.
Does Dr. CHRISTOPHER J BOSARGE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CHRISTOPHER J BOSARGE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).