| Department File Number : | M201886650 |
| Claim Number : | 2161492184US |
| Date Submitted : | 10/9/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| LEXINGTON INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 25-1149494 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | carolyn | r | ewell | ||
| Street Address | |||||
| 17200 W 119th St | |||||
| City | State | Zip | |||
| Olathe | KS | 66061 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (913) 495 - 4217 | carolynranee.ewell@aig.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Jennifer | Garcia | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1951 SW 172nd Ave #404 | ||||
| City | State | Zip Code | County | ||
| Miramar | FL | 33029 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| CNM8239685 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Registered Nurse | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ARNP9190212 | Surgery - Obstetrics - Gynecology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Labor and Delivery Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/3/2014 | 9/21/2015 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| alleges insured CNM failed to appropriately remove placenta causing an inverted uterus, resulting in blood loss and additional hospitalization following the birth of a normal infant. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Failing to timely and appropriately appreciate complications relating to a fundally retained placenta with large fibroid and take appropriate steps to avoid further complications relating thereto including, but not limited, to hemorrhage and uterine inversion. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| alleges insured CNM failed to appropriately remove placenta causing an inverted uterus, resulting in blood loss and additional hospitalization following the birth of a normal infant. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| alleges insured CNM failed to appropriately remove placenta causing an inverted uterus, resulting in blood loss and additional hospitalization following the birth of a normal infant. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 10/5/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 10/3/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $35,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $38,411 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $17,070 | ||||||||||||||||||||
| 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. JENNIFER GARCIA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JENNIFER GARCIA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).