Department File Number : | M201573491 |
Claim Number : | 10403 |
Date Submitted : | 1/7/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FD INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3704679 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tamla | Lloyd | |||
Street Address | |||||
4651 Salisbury Road, Suite 410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 296 - 2887 | 212 | (904) 296 - 1245 | tlloyd@fdinsurancecompany.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Edgar | Bolton | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 7369 Sheridan Street, Suite 302 | ||||
City | State | Zip Code | County | ||
Hollywood | FL | 33024 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
10039 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS2458 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WESTSIDE REG. MED. CTR (PLANTATION) | 100228 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/6/2007 | 11/12/2009 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was admitted to Westside Regional Medical Center on 5/23/07 due to suffering cerebral strokes. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
None shown | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None made | |||||
Principal Injury Giving Rise To The Claim | |||||
On 8/6/07 pt developed respiratory distress and atty is alleging that a chest tube was not timely placed, pt continued to deteriorate and ultimately died. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/4/2010 | 2013-CA-005189-O | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 1/14/2015 | ||||
Other Defendants Involved in this Claim | |||||
HCA, Inc., d/b/a Westside Regional Medical Center Columbia Hospital Corporation of South Broward d/b/a Westsid Edgar B. Bolton, Jr., D.O.P.A. Richard A. Reines, M.D., P.A. Kindred Healthcare, Inc., d/b/a Kindred Hospital South FL KindredHospitals East, LLC d/b/a Kindred Hospital South FL Reines, Richard A | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
1/14/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $30,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $93,684 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Circumstances of this case have been discussed with insured and risk management was notified.Risk management has discussed with insured. |
Updates | |||||||
Date of Change: | 1/7/2016 2:37:39 PM | ||||||
Reason for Change: | Final LAE updated. | ||||||
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Does Dr. EDGAR BOLTON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. EDGAR BOLTON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).