Department File Number : | M201884000 |
Claim Number : | MM276736 |
Date Submitted : | 1/16/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EVANSTON INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2950161 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Karen | Earle-Green | |||
Street Address | |||||
11140 Yellow Poplar Dr | |||||
City | State | Zip | |||
Fort Myers | FL | 33913 | |||
Phone | Ext | Fax | E-Mail Address | ||
(239) 989 - 6462 | khanice@yahoo.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Karen | Earle-Green | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 9981 S HealthPark Circle | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33908 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MM824817 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME101979 | Internal Medicine - No Surgery | 0000 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
LEE MEMORIAL HOSPITAL-HEALTHPARK | 120005 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/3/2014 | 8/3/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
sepsis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No procedures done | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
A case of sepsis in a patient with mitochondrial disease and immunosuppression | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/1/2015 | 10000 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 2/3/2016 | ||||
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 | |||||
Award for plaintiff. | |||||
Date of Payment | |||||
2/3/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $205,910 | ||||||||||||||||||||
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 | |||||||||||||||||||||
This was a presuit. No lawsuit was filed |
Updates | ||||||||||
Date of Change: | 1/16/2018 12:05:02 PM | |||||||||
Reason for Change: | The indemnity amount was updated | |||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201575738 |
Claim Number : | 0AB041696 |
Date Submitted : | 9/9/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HOMELAND INSURANCE COMPANY OF NEW YORK | Primary | ||||
Insurer FEIN | Professional License Number | ||||
52-1568827 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mike | Clark | |||
Street Address | |||||
199 Scott Swamp Road | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 321 - 2544 | (877) 256 - 5067 | mclark@onebeaconpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | KAREN | A | EARLE-GREEN | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 11140 Yellow Poplar Drive | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33913 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MPP393811 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME101979 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | insured involvement was on the diagnosis | ||||
Name of Institution | Code | ||||
LEE MEMORIAL HOSPITAL-CLEVELAND | 100012 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/11/2011 | 6/28/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Abdominal pain consistent with cholycystitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Initial history and physical followed by laparoscopic cholecystectomy with surgical complications resulting in bile duct leak. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged misdiagnosis of gall bladder, calling for unnecessary surgical removal. | |||||
Principal Injury Giving Rise To The Claim | |||||
Leaking bile duct following laparoscopic cholecystectomy. Alleged misdiagnosis of gall bladder, calling for unnecessary surgical removal. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/25/2013 | 11-CA-003002 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 9/8/2015 | ||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
9/8/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $55,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $92,737 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
not known at this time |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Department File Number : | M201678791 |
Claim Number : | 0AB108569 |
Date Submitted : | 6/21/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HOMELAND INSURANCE COMPANY OF NEW YORK | Primary | ||||
Insurer FEIN | Professional License Number | ||||
52-1568827 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Mike | Clark | |||
Street Address | |||||
199 Scott Swamp Road | |||||
City | State | Zip | |||
Farmington | CT | 06032 | |||
Phone | Ext | Fax | E-Mail Address | ||
(860) 321 - 2544 | (877) 256 - 5067 | mclark@onebeacon.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | KAREN | A | EARLE-GREEN | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 9981 South Healthpark Drive | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33908 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PHY071714 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME101979 | Internal Medicine - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Lehigh Regional Medical Center | ||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Inpatient facility | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/1/2012 | 10/29/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Crohn's Disease | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
History and physical followed by podiatry consult with resulting surgery on right foot. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failure to timely diagnose | |||||
Principal Injury Giving Rise To The Claim | |||||
Compartment syndrome in right foot following IV infiltration of Phenergan. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/26/2015 | 2015-CA-530 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 6/9/2016 | ||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
6/20/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $24,762 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not known at this time |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. KAREN EARLE-GREEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KAREN EARLE-GREEN, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).