Department File Number : | M201884753 |
Claim Number : | 1016167-03 |
Date Submitted : | 9/19/2018 |
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 | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Ginge | Brien | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1800 W Hillsboro Blvd | ||||
City | State | Zip Code | County | ||
Deerfield Beach | FL | 33442 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
778210 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME75666 | 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 | ||||
NORTH BROWARD MEDICAL CENTER | 100086 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/1/2012 | 4/14/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
ABDOMINAL PAIN. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
MEDICATION; DIAGNOSTIC TESTING. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
FAILURE TO TIMELY DIAGNOSE BOWEL PERFORATION | |||||
Principal Injury Giving Rise To The Claim | |||||
DEATH. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/4/2014 | CACE-14-006573 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 3/1/2018 | ||||
Other Defendants Involved in this Claim | |||||
Gough-Fibkins MD, Shawn Williams MD, Frederick Unimed Health Systems dba Caps Medical Management LLC North Broward Radiologists PA Gonzalez MD, Pedro J Broward Surgical Associates Inc Delray Trauma Associates PA North Broward Hospital District dba Broward Health Parra MD, Michael W Harold H Rosen MD PA Rosen MD, Harold H Bober PA, Marcy L Borges MD, Abdon S | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
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 | $109,438 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $34,151 | ||||||||||||||||||||
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: | 8/21/2018 11:24:40 AM | |||||||||
Reason for Change: | ALE UPDATE | |||||||||
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Date of Change: | 9/19/2018 12:14:54 PM | |||||||||
Reason for Change: | Updated address due to typo | |||||||||
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Does Dr. GINGE BRIEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GINGE BRIEN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).