Department File Number : | M202091878 |
Claim Number : | MS5010705-02 |
Date Submitted : | 3/18/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL SECURITY INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
56-1600780 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kristen | Janicek | |||
Street Address | |||||
700 Spring Forest Road | |||||
City | State | Zip | |||
Raleigh | NC | 27609 | |||
Phone | Ext | Fax | E-Mail Address | ||
(919) 878 - 7552 | kristen.janicek@curi.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Clifford | Cooper | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 110 Longwood Avenue | ||||
City | State | Zip Code | County | ||
Rockledge | FL | 32955 | Brevard | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EG118876 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Physician Assistant | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9101412 | Emergency Medicine - Including Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Brevard | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WUESTHOFF MEMORIAL HOSPITAL | 23960034 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/25/2014 | 10/31/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Ischemic bowel requiring bowel resection | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Plaintiff alleged emergency room providers delayed diagnosis of ischemic bowel | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Ischemic bowel requiring bowel resection | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/15/2017 | 05-2017-CA-018698 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Brevard | 3/2/2020 | ||||
Other Defendants Involved in this Claim | |||||
DONTINENI, SRINIVAS Rosario, Aldo Srinivas Dontineni, MD, PA d/b/a Brevard Hospitalist Assoc. Velarde, Diego Advanced Surgical & Weight Loss Institute, LLC Elmaghraby, Zaki Independent Physicians Resource, Inc. Maynard, PA, Amber Hession, Rory Independent Lung Associates, PA ApolloMD Physician Services FL, LLC ApolloMD Business Services, LLC Floridian Emergency Specialists, LLC Melbourne HMA, LLC d/b/a Wuesthoff Medical Center | |||||
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 not subject to Arbitration. | |||||
Date of Payment | |||||
3/13/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $62,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $102,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Indemnity payment of $62,500 for this practitioner |
Updates | |
No updates found. |
Does Dr. CLIFFORD COOPER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CLIFFORD COOPER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).