Department File Number : | M201679742 |
Claim Number : | 1022060-01 |
Date Submitted : | 2/21/2017 |
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 | Donald | J | Perry | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 2051 Mayo Drive | ||||
City | State | Zip Code | County | ||
Tavares | FL | 32778 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
618428 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67984 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lake | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Radnothy-Perry Orthopaedic Center PA | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/9/2012 | 10/24/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Left elbow fracture | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Long arm cast applied | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to perform reduction | |||||
Principal Injury Giving Rise To The Claim | |||||
Displaced elbow; need for second surgery | |||||
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 | ||||
9/23/2015 | 35-2015-CA-001757 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lake | 9/15/2016 | ||||
Other Defendants Involved in this Claim | |||||
Francis PA, Danielle M Radnothy-Perry Orthopaedic Center PA | |||||
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 | |||||
8/16/2016 |
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 | $7,022 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,024 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $83,333 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
Updates | ||||||||||
Date of Change: | 9/26/2016 8:25:41 AM | |||||||||
Reason for Change: | Updated treatment field per request of file manager | |||||||||
| ||||||||||
Date of Change: | 2/21/2017 11:06:08 AM | |||||||||
Reason for Change: | ALE UPDATE 2/21/2017 | |||||||||
|
This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Does Dr. DONALD J PERRY, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DONALD J PERRY, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).