Department File Number : | M202092390 |
Claim Number : | 027-094056 |
Date Submitted : | 5/5/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LEXINGTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
25-1149494 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | carolyn | r | ewell | ||
Street Address | |||||
17200 W 119th St | |||||
City | State | Zip | |||
Olathe | KS | 66061 | |||
Phone | Ext | Fax | E-Mail Address | ||
(913) 495 - 4217 | carolynranee.ewell@aig.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | M | Ericson | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 4538 Gulfstream Drive | ||||
City | State | Zip Code | County | ||
Spring Hill | FL | 34607 | Pasco | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1005285 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Registered Nurse | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ARNP2150942 | Physicians or Surgeons Assistants |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BONITA COMMUNITY HEALTH CENTER | 14960412 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/6/2006 | 12/1/2008 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
39 y/o female alleged negligent monitoring by insured RN post back surgery; Dural leak,14 surgeries and permanent injuries | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged spinal injuries and negligent care, treatment and failure to care in a proper medical environment. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Back surgery resulting in neurological residuals. | |||||
Principal Injury Giving Rise To The Claim | |||||
39 y/o female alleged negligent monitoring by insured RN post back surgery; Dural leak,14 surgeries and permanent injuries | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 10/3/2019 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
10/28/2019 |
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 | $112,752 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $39,226 | ||||||||||||||||||||
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. |
Does Dr. DENISE M ERICSON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DENISE M ERICSON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).