Department File Number : | M201989956 |
Claim Number : | 158812-2 |
Date Submitted : | 9/13/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Christina | J | Stoker | ||
Street Address | |||||
1100 Dr. Martin Luther King Jr. Blvd, Ste. 500 | |||||
City | State | Zip | |||
Nashville | TN | 37203 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 1779 | (866) 715 - 7235 | christina.stoker@hcahealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | ELISABETH | D | TUCKER | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8383 N DAVIS HIGHWAY | ||||
City | State | Zip Code | County | ||
PENSACOLA | FL | 32514 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10114 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME52064 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WEST FLORIDA REG. MED. CTR (PENSACOLA) | 100231 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/28/2014 | 7/28/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PELVIC PAIN, ENDOMETRIOSIS, CYSTEOCELE, RECTOCELE, STRESS URINARY INCONTINENCE. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
DIAGNOSTIC LAPAROSCOPY, LYSIS OF ADHESIONS, LAPAROTOMY, BILATERAL SALPINGO-OOPHORECTOMY, ANTERIOR AND POSTERIOR REPAIR. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
LEFT URETER LACERATION | |||||
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 | ||||
3/28/2017 | 2017-CA-000461 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Escambia | 8/19/2019 | ||||
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 | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/7/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $500,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $248,827 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $46,305 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $30,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
REFERRED TO RISK MANAGEMENT. |
Updates | |
No updates found. |
Does Dr. ELISABETH D TUCKER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ELISABETH D TUCKER, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).