Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M201679294 |
Claim Number : | 70155A |
Date Submitted : | 7/29/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | James | P | Lacey | ||
Street Address | |||||
245 Riverside Avenue, Suite 550 | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(855) 663 - 3625 | 127 | (888) 974 - 6458 | jlacey@medmaldirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | KIMBERLY | VAN SCRIVER | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2756 Oak Vista Lane | ||||
City | State | Zip Code | County | ||
Castle Rock | CO | 80104 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707531 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME73993 | Gynecology - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SAINT LUKES' HOSPITAL | 100151 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Labor and Delivery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/9/2011 | 2/21/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Term pregnancy delivery. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
vaginal delivery with should dystocia maneuvers. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Shoulder dystocia. | |||||
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 | ||||
12/4/2013 | 2013-ca-010072 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 5/2/2016 | ||||
Other Defendants Involved in this Claim | |||||
Phoenix, Ava Brady, Evelyn K | |||||
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 | |||||
5/12/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $83,333 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $24,714 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Discussed case with insured. |
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.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
This page is not displaying certain sensitive information. |
Does Dr. KIMBERLY VAN SCRIVER, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KIMBERLY VAN SCRIVER, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).