Department File Number : | M201575458 |
Claim Number : | 1018355 |
Date Submitted : | 2/4/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-6021331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Marissa | A | Brubaker | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0353 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dwight | A | Townsend | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 100S Ashley Dr | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33602 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
ME99052 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME99052 | Radiology - therapeutic - no surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Carrollwood Hospital | ||||
Date of Occurrence | Date Reported to Insurer | ||||
12/17/2011 | 3/11/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Back pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Monitoring in hospital | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to order neuro evaluation | |||||
Principal Injury Giving Rise To The Claim | |||||
Paraplegia | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 6/15/2015 | ||||
Other Defendants Involved in this Claim | |||||
Grant-Levy, DO, Tatia R Tampa Bay Emergency Physicians Kamat, MD, Shrinath S Shrinath S Kamat MD, PA Edington, MD, Simon R | |||||
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 | |||||
6/15/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $850,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $14,995 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $15,336 | ||||||||||||||||||||
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 | ||||||||||||||||||||||
Date of Change: | 8/11/2015 8:35:11 AM | |||||||||||||||||||||
Reason for Change: | Updated defendants and settlement amount | |||||||||||||||||||||
| ||||||||||||||||||||||
Date of Change: | 9/2/2015 7:24:15 AM | |||||||||||||||||||||
Reason for Change: | Updated issue company | |||||||||||||||||||||
| ||||||||||||||||||||||
Date of Change: | 2/4/2016 4:15:07 PM | |||||||||||||||||||||
Reason for Change: | ALE update and corrected Loss Indemnity payment. | |||||||||||||||||||||
|
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201783706 |
Claim Number : | CLFL4695A |
Date Submitted : | 11/27/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CENTURION MEDICAL LIABILITY PROTECTIVE RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-1145017 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | LETIA | S | SHELTON | ||
Street Address | |||||
3100 S GESSNER ROAD STE 600 | |||||
City | State | Zip | |||
HOUSTON | TX | 77084 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 353 - 1624 | LETIA.SHELTON@ESIS.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | DWIGHT | A | TOWNSEND | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 702 S BELLA VISTA ST | ||||
City | State | Zip Code | County | ||
TAMPA | FL | 33609 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL4695 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME99052 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | OUTPATIENT FACILITY | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/7/2015 | 9/2/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
TUMOR | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
FAILURE TO DIAGNOSE | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
LOWER BACK PAIN/FAILURE TO DIAGNOSE | |||||
Principal Injury Giving Rise To The Claim | |||||
FAILURE TO DIAGNOSE TUMOR | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/2/2016 | 2016M040 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 6/19/2017 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
7/1/2017 |
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 | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
UNKNOWN AT THIS TIME |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. DWIGHT A TOWNSEND, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DWIGHT A TOWNSEND, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).