Department File Number : | M201574866 |
Claim Number : | EMC-AO-13XS-272845-A |
Date Submitted : | 6/5/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
EmCare Holdings, Inc. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
75-173235 | SI | ||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
9821 Katy Freeway | |||||
City | State | Zip | |||
Houston | TX | 77024 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MELISSA | THIELE | |||
Insurer Type | Street Address of Practice | ||||
Self-Insurer | 1794 HARBOR CIRCLE EAST | ||||
City | State | Zip Code | County | ||
LARGO | FL | 33770 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EMC-2013-Excess | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | PHYSICIAN ASSISTANT | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9100790 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
LARGO MEDICAL CENTER | 100248 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/3/2011 | 6/5/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
FALL AND INJURED KNEE | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EXAMINATION AND X-RAY | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
LATERAL LIGAMENT DAMAGE; MENISCAL INJURY AND JOINT EFFUSION | |||||
Principal Injury Giving Rise To The Claim | |||||
HEMATOMA R/I LEFT FOOT DROP | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/10/2013 | 13-006120-CI-7 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 5/22/2015 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
4/27/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $110,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $101,046 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,693 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
Updates | |
No updates found. |
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Department File Number : | M201574867 |
Claim Number : | EMC-AO-13XS-272845 |
Date Submitted : | 6/5/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CONTINENTAL CASUALTY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2114545 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kathy | A | Stockton | ||
Street Address | |||||
9821 Katy Freeway | |||||
City | State | Zip | |||
Houston | TX | 77024 | |||
Phone | Ext | Fax | E-Mail Address | ||
(713) 935 - 2404 | (713) 461 - 8130 | kathy_stockton@westernlitigation.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | MELISSA | THIELE | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1794 HARBOR CIRCLE EAST | ||||
City | State | Zip Code | County | ||
LARGO | FL | 33770 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HAZ1040025381-11 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Other | PHYSICIAN ASSISTANT | ||||
License Number | Specialty Code & Classification | Certification Number | |||
PA9100790 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
LARGO MEDICAL CENTER | 100248 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | ER | ||||
Date of Occurrence | Date Reported to Insurer | ||||
6/3/2011 | 6/5/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
FALL AND INJURED KNEE | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
EXAMINATION AND X-RAY | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
LATERAL LIGAMENT DAMAGE; MENISCAL INJURY AND JOINT EFFUSION | |||||
Principal Injury Giving Rise To The Claim | |||||
HEMATOMA R/I LEFT FOOT DROP | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/10/2013 | 13-006120-CI-7 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 5/22/2015 | ||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
4/27/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $14,176 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,500 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Unknown |
Updates | |
No updates found. |
This page is not displaying certain sensitive information.
Does Dr. MELISSA THIELE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MELISSA THIELE, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).