| Department File Number : | M201885102 |
| Claim Number : | WC/108888-17 |
| Date Submitted : | 4/18/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Watson Clinic LLP | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-070493 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Diane | Szymanski | |||
| Street Address | |||||
| 1600 Lakeland Hills Blvd | |||||
| City | State | Zip | |||
| Lakeland | FL | 33805 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (863) 680 - 7620 | (863) 616 - 2430 | aszymanski@watsonclinic.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Elisabeth | Dupont | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 1600 Lakeland Hills Blvd. | ||||
| City | State | Zip Code | County | ||
| Lakeland | FL | 33805 | Polk | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PH1605501-PL | $2,000,000 | $18,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME76168 | Surgery - General Practice or Family Practice | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Polk | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | Watson Clinic LLP; Women's Center | ||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Diagnostic Exam Room | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/22/2016 | 8/29/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient was referred to Dr. Dupont's office from an outside provider office for evaluation of a palpable area of concern in the right breast and abnormal finding on a diagnostic mammogram and ultrasound of the right breast. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Patient was seen, evaluated, and referred to Watson Clinic Women's Imaging by Dr. Dupont's ARNP on 6/17/2016. Dr. Dupont was not involved in the evaluation of this patient until she returned six months later for her follow-up visit in January 2017. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| This case involved a delayed diagnosis of an invasive ductal carcinoma. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Unfortunately, when the patient returned six months later, she was diagnosed with an invasive ductal carcinoma. Following an ultrasound-guided aspiration and core biopsy of a mass in her right breast, the patient was diagnosed on 1/6/2017 with lymph node positive triple negative cancer. The patient underwent aggressive treatment, but unfortunately, died on 1/5/2018. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 3/23/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| 3/23/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $300,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $19,093 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $4,782 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Circumstances of event reviewed with individual parties involved. | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. ELISABETH DUPONT, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ELISABETH DUPONT, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).