Department File Number : | M201782709 |
Claim Number : | 9941.216 |
Date Submitted : | 8/3/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SOUTH PINELLAS MEDICAL TRUST | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6599936 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Andrew | L | Wallace | ||
Street Address | |||||
341 3rd Street S | |||||
City | State | Zip | |||
St. Petersburg | FL | 33701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(727) 822 - 4600 | (727) 822 - 4665 | awallacespmt@gmail.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Derek | B | Hess | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 601 Fifth Street South, Suite 601 | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33701 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
38991-15 | $750,000 | $1,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Opthalmology | ||||
License Number | Specialty Code & Classification | Certification Number | |||
ME88485 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
ALL CHILDREN'S HOSPITAL | 100250 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/17/2012 | 3/23/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Persistent hyperplastic primary vitreous in one month old. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Allegedly, extracapsular cataract extraction, secondary membrane removal and/or anterior vitrectomy. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None. | |||||
Principal Injury Giving Rise To The Claim | |||||
Detached retina right eye. | |||||
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 | ||||
7/13/2015 | 15-004446-CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 7/13/2017 | ||||
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 | ||||
Other | Settled at mediation. | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
7/13/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $650,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $18,358 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Based on physician's review of treatment and positive expert reviews by two nationally recognized experts, none deemed to be necessary. |
Updates | |
No updates found. |
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Does Dr. DEREK B HESS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DEREK B HESS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).