Department File Number : | M201678752 |
Claim Number : | 1022973-01 |
Date Submitted : | 9/13/2017 |
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 | Myra | Lassen | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(800) 463 - 3776 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Eve | Jehle | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 22393 Mizell Road | ||||
City | State | Zip Code | County | ||
Brooksville | FL | 34601 | Pasco | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HN006099 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME43093 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hernando | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Bayfront Health Spring Hills | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/28/2014 | 12/11/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Dizziness and headache | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Read of MRi | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to diagnose stroke and bilateral internal carotid artery dissection | |||||
Principal Injury Giving Rise To The Claim | |||||
Hemiparalysis and global aphasia | |||||
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 | 6/8/2016 | ||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $950,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $65,112 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | |||||||
Date of Change: | 9/13/2017 10:13:02 AM | ||||||
Reason for Change: | Updated ALE | ||||||
|
*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 : | M201987756 |
Claim Number : | 1036731-03 |
Date Submitted : | 1/30/2019 |
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 | Michelle | Pierron | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(800) 463 - 3776 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Eve | Jehle | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 100 S Ashley Dr | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33603 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HN006099 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME43093 | Radiology - Diagnostic - Minor 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 | ||||
BAYFRONT MEDICAL CENTER | 100032 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/5/2014 | 9/8/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Severe headache, nausea, vomiting | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Read of a CTA of the head and a CT of the brain | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to diagnose aneurysm and place aneurysm on the differential diagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Death from brain bleed | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 1/16/2019 | ||||
Other Defendants Involved in this Claim | |||||
Bayfront Health Brooksville | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After arbitration is initiated or prior to suit being filed. | |||||
Final Method of Claim Disposition | |||||
Dropped before Action Filed | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $22,728 | ||||||||||||||||||||
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 | |||||||||||||||||||||
NA |
Updates | |
No updates found. |
Department File Number : | M201575901 |
Claim Number : | 1024705-02 |
Date Submitted : | 1/28/2016 |
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 | Susan | K | Spielman | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Fort Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0340 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Eve | M | Jehle | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 901 Clearwater Largo Road North | ||||
City | State | Zip Code | County | ||
Largo | FL | 33770 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
741579 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME43093 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Citrus | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
CITRUS MEMORIAL HOSPITAL | 100023 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/9/2011 | 3/4/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Chest discomfort, respiratory distress, cough | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
2 chest X-rays and chest CT | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to detect and report spiculated densities in upper lobe of right lung | |||||
Principal Injury Giving Rise To The Claim | |||||
Lung cancer | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 9/15/2015 | ||||
Other Defendants Involved in this Claim | |||||
Associated Radiologists of Inverness PA Ceballos MD, Thomas K Feick MD, Steven W | |||||
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 | |||||
Dropped before Action Filed | |||||
Court Decision | Other | ||||
Other | Not Pursued | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $10,610 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,038 | ||||||||||||||||||||
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: | 1/28/2016 9:38:15 AM | |||||||||
Reason for Change: | ALE UPDATE 1/28/2016 | |||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. EVE JEHLE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. EVE JEHLE, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).