| Department File Number : | M201573640 |
| Claim Number : | 12868 |
| Date Submitted : | 2/27/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Univ of FL JHMHC Self-Insurance Program | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-600205 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Merry | C | Reid | ||
| Street Address | |||||
| 201 S. E. Second Avenue, Suite 208 | |||||
| City | State | Zip | |||
| Gainesville | FL | 32601 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (352) 273 - 7006 | (352) 273 - 5424 | REIDM@ufl.edu | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | H | G | JAMES | ||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 580 W. Eighth Street | ||||
| City | State | Zip Code | County | ||
| Jacksonville | FL | 32209 | Duval | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| UFBOT11J | $300,000 | *NR | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME54919 | Emergency Medicine - No Major Surgery | ||||
| 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 | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| WINTER HAVEN HOSPITAL | 100052 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Emergency Room | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/26/2012 | 1/10/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Methicillin-sensitive staphylococcus aureus | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Delay in informing patient of positive blood cultures | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Urinary Tract Infection | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Bacterial endocarditis and acute stroke | |||||
| Severity Of Injury | |||||
| Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/19/2013 | 2013-CA-003240 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Polk | 2/3/2015 | ||||
| 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 | |||||
| 2/3/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $31,321 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $4,801 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Assessment of treatment with physician | |||||||||||||||||||||
| 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. H G JAMES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. H G JAMES, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).