Department File Number : | M201782680 |
Claim Number : | 214584 |
Date Submitted : | 10/10/2017 |
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 | John | C | Tomberlin | ||
Insurer Type | Street Address of Practice | ||||
Licensed | PO Box 789 | ||||
City | State | Zip Code | County | ||
Geneva | AL | 36340 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP408 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME60438 | Radiology - Diagnostic - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Holmes | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
DOCTORS' MEMORIAL HOSPITAL (BONIFAY) | 100078 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/29/2014 | 8/26/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Left-sided temporal contusion and bruising at multiple injury sites on the head and body following an assault by a family member in the patient's home. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
CT scan of the head | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
a subtle finding of a subdural hematoma was not identified in the reading of the CT scan | |||||
Principal Injury Giving Rise To The Claim | |||||
Although the patient was not taken by his family for further treatment despite experiencing significant deterioration in his condition until he became unresponsive 6 days after the initial treatment and scan, plaintiff alleged the failure to note the minimal subdural hematoma in the reading the CT scan resulted in the death of the patient. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/21/2017 | 2017-0002-CAA | ||||
County Suit Filed in | Date of Final Disposition | ||||
Holmes | 7/19/2017 | ||||
Other Defendants Involved in this Claim | |||||
Wiregrass Radiological Consultants Wiregrass Medical Center | |||||
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 | |||||
7/27/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $450,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $32,974 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $6,890 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $450,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discussed case with defense counsel, insureance personnel, and medical experts. |
Updates | ||||||||||
Date of Change: | 7/31/2017 4:55:26 PM | |||||||||
Reason for Change: | updated ALAE information | |||||||||
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Date of Change: | 9/29/2017 12:40:24 PM | |||||||||
Reason for Change: | Updated ALAE information | |||||||||
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Date of Change: | 10/10/2017 12:21:45 PM | |||||||||
Reason for Change: | Updated ALAE information | |||||||||
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Department File Number : | M201989210 |
Claim Number : | 69528 |
Date Submitted : | 6/28/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (404) 842 - 3319 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | C | Tomberlin | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1200 W Maple Ave Ste 300 | ||||
City | State | Zip Code | County | ||
Geneva | AL | 36340 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 15000972 00 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME60438 | Radiology - Diagnostic - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Holmes | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
DOCTORS' MEMORIAL HOSPITAL (BONIFAY) | 100078 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/20/2017 | 7/12/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Bowel perforation | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No iatrogenic injury | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to identify and report free air on CT of the abdomen and pelvis | |||||
Principal Injury Giving Rise To The Claim | |||||
Bowel perforation | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/21/2018 | 2018-CA-000402 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Holmes | 6/4/2019 | ||||
Other Defendants Involved in this Claim | |||||
South Alabama Diagnostic Imaging Amin, MD, Muhammad Doctor's Memorial Hospital | |||||
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 | |||||
6/4/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $450,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $20,132 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $4,769 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk Management has counseled insured |
Updates | |
No updates found. |
Does Dr. JOHN C TOMBERLIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN C TOMBERLIN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).