Department File Number : | M201884074 |
Claim Number : | 1027002-01 |
Date Submitted : | 3/26/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | L | Andrade | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3500 Tyler St | ||||
City | State | Zip Code | County | ||
Hollywood | FL | 33021 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
A14127 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Physicians Assistant | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9100997 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MEMORIAL REGIONAL HOSPITAL(HOLLYWOOD) | 100038 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/16/2012 | 6/19/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Herniated disks L3/4 and L4/5 | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Numerous surgeries, failed hardware and nonunion | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Unnecessary surgery improper technique | |||||
Principal Injury Giving Rise To The Claim | |||||
Left leg instability, debilitating back pain | |||||
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 | ||||
12/8/2014 | 14023318 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 1/5/2018 | ||||
Other Defendants Involved in this Claim | |||||
Katzman MD, Scott Advanced Orphopedics LLC Scott Katzman MD PA Advanced Orthopedics & Pain Management PL International Spine Institute LLC | |||||
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 | |||||
No Payment Made | |||||
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? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $3,822 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $573 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
n/a |
Updates | |||||||
Date of Change: | 3/26/2018 1:44:05 PM | ||||||
Reason for Change: | Updated of occurrence date | ||||||
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Does Dr. DENISE L ANDRADE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DENISE L ANDRADE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).