Department File Number : | M201677634 |
Claim Number : | FP4382801 |
Date Submitted : | 3/18/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JACK | G | BEAULIEU | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 657 Del Prado Blvd., S. | ||||
City | State | Zip Code | County | ||
Cape Coral | FL | 33990 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-CL099019 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME29197 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
CAPE CANAVERAL HOSPITAL | 100177 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/12/2011 | 11/28/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Cellulitis, advanced osteoarthritis of left knee. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Left total knee replacement. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None, this insured's only involvement was to assist primary surgeon. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient developed necrosis and MRSA infection post left knee replacement eventually requiring left above knee amputation. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/1/2013 | 13CA0001734 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 3/11/2016 | ||||
Other Defendants Involved in this Claim | |||||
Nassif, Roderick Gulf Shore Internal Medicine Cape Coral, LLC | |||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | Dismissal for the defendant | ||||
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 | $94,666 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $36,791 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
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Does Dr. JACK G BEAULIEU, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JACK G BEAULIEU, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).