Department File Number : | M201783564 |
Claim Number : | PLFHMGO089143 |
Date Submitted : | 11/3/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
Florida Physicians Medical Group | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-3214635 | 800014080 | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Linda | Boelke | |||
Street Address | |||||
900 Hope Way | |||||
City | State | Zip | |||
Altamonte Springs | FL | 32714 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 357 - 1313 | linda.boelke@ahss.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Jane | Cook | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 2600 Westhall Lane, 4th Floor | ||||
City | State | Zip Code | County | ||
Maitland | FL | 32751 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
8258 - 2016 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10449 | Radiology - Diagnostic - No 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 | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
FLORIDA HOSPITAL (ORLANDO) | 100007 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Special Procedure Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/11/2014 | 11/3/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Ongoing severe headaches and nausea. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
MRI pediatric brain study. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged negligent failure to appropriately read MRI Brain study depicting rare benign ganglioglioma that resulted in delayed diagnosis, alleged growth of the tumor, and narrowed treatment options. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 10/16/2017 | ||||
Other Defendants Involved in this Claim | |||||
Florida Hospital Medical Group | |||||
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 | |||||
10/16/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |
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. JANE COOK, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JANE COOK, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).