Department File Number : | M201677080 |
Claim Number : | EMC-AO-13XS-272835-2 |
Date Submitted : | 2/10/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EmCare Holdings, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
75-173235 | SI | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
9821 Katy Freeway | |||||
City | State | Zip | |||
Houston | TX | 77024 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DAVID | CABEZAS | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 301 VIEW POINT PLACE | ||||
City | State | Zip Code | County | ||
ST AUGUSTINE | FL | 32080 | Flagler | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EMC-2013-Excess | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME108022 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Flagler | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
FLAGLER HOSPITAL | 100219 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/6/2011 | 9/10/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
FOREIGN BODY IN EYE | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EXAMINED AND UNABLE TO DETECT FOREIGN BODY IN EYE. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
CORNEAL ABRASION | |||||
Principal Injury Giving Rise To The Claim | |||||
LOSS OF VISION | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/26/2013 | 201331821CICI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Volusia | 1/28/2016 | ||||
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 | |||||
1/28/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $43,845 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $8,457 | ||||||||||||||||||||
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 | |||||||||||||||||||||
UNKNOWN |
Updates | |
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Does Dr. DAVID CABEZAS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DAVID CABEZAS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).