Department File Number : | M202092661 |
Claim Number : | 1065920-01 |
Date Submitted : | 6/5/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
35-0506406 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lynn | Louthan | |||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0778 | reportaclaim@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Judith | A | Kaltenbach | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8215 Lake Ross Ln | ||||
City | State | Zip Code | County | ||
Sanford | FL | 32771 | Seminole | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
F68242 | $100,000 | $300,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | Physicians Assistant | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA3205 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Seminole | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/28/2017 | 9/11/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
fever, body aches, chills, muscle pain | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
exam, diagnose with influenza | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
failure to properly diagnose and treat | |||||
Principal Injury Giving Rise To The Claim | |||||
diagnosed with legionella pneumonia and ultimately died | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/4/2019 | 2019-CA-001760-09M-L | ||||
County Suit Filed in | Date of Final Disposition | ||||
Seminole | 5/12/2020 | ||||
Other Defendants Involved in this Claim | |||||
Panuccio MD, Denise Denise Panuccio MD PA dba Altamonte Medical Group Adventist Health System/Sunbelt Inc dba Centra Care | |||||
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 | |||||
5/12/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $25,289 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $9,313 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $100,000 | ||||||||||||||||||||
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. |
Does Dr. JUDITH A KALTENBACH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JUDITH A KALTENBACH, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).