Department File Number : | M201783895 |
Claim Number : | PLFHTA087225 |
Date Submitted : | 12/20/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
University Community Hospital | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-1113901 | 4035 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Linda | Boelke | |||
Street Address | |||||
900 Hope Way | |||||
City | State | Zip | |||
Altamonte Springs | FL | 32714 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 357 - 1313 | linda.boelke@ahss.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | David | Decker | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 5811 Interbay Blvd | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33611 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
8258 - 2016 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME100336 | Surgery - Neurology - Including Child |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
University Community Hospital | 100173 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/15/2015 | 5/24/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Presented to ED via EMS under stroke alert for severe headache and altered mental status. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Neurological examination and CT of the brain. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Involved was the alleged negligent failure of the physician to properly interpret and report on CT results; which plaintiff claimed resulted in delayed recognition and treatment of acute left brainstem infarct and residual cognitive impairments. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/9/2016 | 16-CA-011155 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 11/21/2017 | ||||
Other Defendants Involved in this Claim | |||||
Florida Hospital Tampa | |||||
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 | |||||
11/21/2017 |
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 | |||||||||||||||||||||
N/A |
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. DAVID DECKER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DAVID DECKER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).