Department File Number : | M201885832 |
Claim Number : | MM273620 |
Date Submitted : | 7/9/2018 |
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 | DAVID | L | HICKS | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3165 N MCMULLEN BOOTH ROAD; SUITE H | ||||
City | State | Zip Code | County | ||
CLEARWATER | FL | 33761 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MM824727 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS4796 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pasco | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Patient's Home | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/15/2013 | 11/20/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PULMONARY CONGESTION, EDEMA, CARDIOMEGALY, MARKED CORONARY ARTERY ATHEROSCLEROSIS, A BICUSPID AORTIC VALVE, THICKENING OF THE MITRAL VALVE AND AN AORTIC VALVE OF THE HEART, CONGESTION OF THE LIVER, LUPUS AND COPD | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
ALLEGE EXCESSIVE PRESCRIBING OF MEDICATIONS | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
NO MISDIAGNOSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
OVERDOSE OF VALLIUM | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/7/2015 | 150021196CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 3/13/2018 | ||||
Other Defendants Involved in this Claim | |||||
PROMISE PHARMACY LLC | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
3/5/2018 |
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 | $47,757 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $7,500 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
NONE |
Updates | |
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Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Does Dr. DAVID L HICKS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DAVID L HICKS, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).