Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
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Department File Number : | M201472525 |
Claim Number : | 151913 |
Date Submitted : | 11/4/2014 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lon | Boutiette | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 100 Mar Walt Drive | ||||
City | State | Zip Code | County | ||
Fort Walton Beach | FL | 32547 | Okaloosa | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-CT-10112 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME51154 | Emergency Medicine - No Major Surgery | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Okaloosa | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
FORT WALTON BEACH MEDICAL CENTER | 100223 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Emergency Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
5/1/2012 | 3/26/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Rattlesnake bite, 2nd digit, right hand with envenomation. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient presented to ER for rattlesnake bite. Allege improper diagnosis of "dry bite" & discharged without treatment. The next day patient was admitted to Sacred Heart Hospital when symptoms worsened due to rattlesnake envenomation. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Delayed treatment of rattlesnake bite. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 10/24/2014 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After arbitration is initiated or prior to suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
10/7/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $30,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $1,389 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,632 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Staff education. |
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.
Department File Number : | M201573488 |
Claim Number : | FL-TEG-13-ERP |
Date Submitted : | 2/12/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
APPLIED MEDICO-LEGAL SOLUTIONS RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
81-0603029 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Julie | Moore | |||
Street Address | |||||
101 E. Park Blvd. | |||||
City | State | Zip | |||
Plano | TX | 75074 | |||
Phone | Ext | Fax | E-Mail Address | ||
(866) 520 - 6896 | jmontague@bpmp.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Lon | A | Boutiette | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 100 Mar Walt Drive | ||||
City | State | Zip Code | County | ||
Fort Walton Beach | FL | 32547 | Okaloosa | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
G-AMS-115975-ERP | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME51154 | Emergency Medicine - No Major Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Okaloosa | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
FORT WALTON BEACH MEDICAL CENTER | 100223 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Radiology, Emergency Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/1/2012 | 4/16/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Snake bite. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No treatment given, observation only. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Diagnosed as "dry' bite. | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient developed symptoms and was treated with anti-venom. | |||||
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 | 2/11/2015 | ||||
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 | |||||
10/9/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $30,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $4,580 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Contact poison control for all snake bites. |
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. LON A BOUTIETTE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. LON A BOUTIETTE, MD has at least 3 medical malpractice case(s), lawsuit(s), or complaint(s).