Department File Number : | M201782875 |
Claim Number : | 1031136 |
Date Submitted : | 8/21/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL FIRE & MARINE INSURANCE COMPANY | Excess | ||||
Insurer FEIN | Professional License Number | ||||
47-6021331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Pamela | A | Prudlow | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft. Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0370 | (260) 486 - 0785 | pamela.prudlow@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Frank | C | Riggall | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 795 Primera Blvd, Suite 1001 | ||||
City | State | Zip Code | County | ||
Lake Mary | FL | 32746 | Seminole | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EN007040 | $2,500,000 | $2,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME19309 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Orange | ||||
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 | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/22/2015 | 12/31/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Right salpingectomy, left tuboplasty, enterolysis, hysteroscopy and endrometrial polypectomy. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Surgery. Post-op care. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged negligence related to post-operative discovery of bowel perforation. | |||||
Principal Injury Giving Rise To The Claim | |||||
Fistula from bowel perforation. | |||||
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 | ||||
9/7/2016 | 2016-CA-7920-0 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Orange | 7/21/2017 | ||||
Other Defendants Involved in this Claim | |||||
Winnie Palmer Hospital for Women & Babies | |||||
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 | |||||
6/26/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $991,730 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $534,730 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
n/a |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201782777 |
Claim Number : | IA-15-316030 |
Date Submitted : | 8/9/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
INTEGRAMED AMERICA, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
06-115032 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
1900 W. LOOP S., STE. 1500 | |||||
City | State | Zip | |||
Houston | TX | 77027 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | FRANK | RIGGALL | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 795 PRIMERA BLVD., STE. 1001 | ||||
City | State | Zip Code | County | ||
LAKE MARY | FL | 32746 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
IA-SIR-15 | $500,000 | $500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME19309 | Gynecology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | CENTER FOR REPRODUCTIVE MEDICINE | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Special Procedure Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/22/2015 | 8/12/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
ADHESIOLYSIS | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
UNDERWENT ADHESIOLYSIS | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
ALLEGED SMALL BOWEL INJURY DURING ADHESIOLYSIS | |||||
Principal Injury Giving Rise To The Claim | |||||
SMALL BOWEL INJURY | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 7/14/2017 | ||||
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 | |||||
6/19/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $933,270 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $50,049 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $16,681 | ||||||||||||||||||||
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 |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. FRANK C RIGGALL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FRANK C RIGGALL, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).