Department File Number : | M201987584 |
Claim Number : | SM400448 |
Date Submitted : | 1/11/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EVANSTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2950161 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | CRYSTAL | L | ALSTON-BAYTON | ||
Street Address | |||||
4600 COX ROAD | |||||
City | State | Zip | |||
GLEN ALLEN | VA | 23060 | |||
Phone | Ext | Fax | E-Mail Address | ||
(804) 864 - 3731 | (855) 662 - 7535 | CALSTONBAYTON@MARKELCORP.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | CYNTHIA | D | MCDONALD | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 6841 45TH ST | ||||
City | State | Zip Code | County | ||
LAUDERHILL | FL | 33319 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SM910916 | $1,000,000 | $5,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | MEDICAL DENTAL BEHAVIOR HEALTH | ||||
License Number | Specialty Code & Classification | Certification Number | |||
RN9305620 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Prison | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | INFIRMARY | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/7/2016 | 4/7/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PERITONITIS | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
FAILURE TO DIAGNOSIS PERITONITIS | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
DEATH CAUSED BY PERITONITIS SECONDARY TO A RUPTURED DIVERTICULUM | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/26/2017 | 017CV62007DPG | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 5/31/2018 | ||||
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 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 | $3,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,708 | ||||||||||||||||||||
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 | |||||||||||||||||||||
NONE |
Updates | |
No updates found. |
Does Dr. CYNTHIA D MCDONALD, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. CYNTHIA D MCDONALD, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).