| Department File Number : | M201782113 |
| Claim Number : | 206583 |
| Date Submitted : | 12/13/2017 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PROASSURANCE CASUALTY COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 38-2317569 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Denise | Stokes | |||
| Street Address | |||||
| 100 Brookwood Place | |||||
| City | State | Zip | |||
| Birmingham | AL | 35209 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | JAMES | J | MC CLELLAND | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3000 N Orange Ave, Suite A | ||||
| City | State | Zip Code | County | ||
| Orlando | FL | 32804 | Orange | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MP66442 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME37387 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Orange | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| FLORIDA HOSPITAL (ORLANDO) | 100007 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 6/9/2013 | 8/21/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Back pain | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Infectious Disease Consultation | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| 45 YOM alleges failure to timely repeat MRI resulted in extension of L-4 paraspinal abscess into the epidural space necessitating emergent surgery and causing ongoing back and right lower extremity pain. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 1/7/2016 | 2015-CA-011437-0 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Orange | 5/11/2017 | ||||
| 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 | |||||
| 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 | $33,874 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $18,396 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Insured discussed case with defense counsel, insurance personnel, and medical experts. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 7/12/2017 4:39:56 PM | |||||||||
| Reason for Change: | updated ALAE informaiton | |||||||||
| ||||||||||
| Date of Change: | 9/29/2017 3:27:25 PM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
| ||||||||||
| Date of Change: | 12/13/2017 9:30:42 AM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
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Does Dr. JAMES J MC CLELLAND, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JAMES J MC CLELLAND, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).