| Department File Number : | M201885466 |
| Claim Number : | EHC-SHI-17-368392 |
| Date Submitted : | 6/6/2018 |
| 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 | |||||
| 1900 W. LOOP S., STE. 1500 | |||||
| City | State | Zip | |||
| Houston | TX | 77027 | |||
| 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 | NORMAN | SHEPPLE | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 1613 NORTH HARRISON PARKWAY | ||||
| City | State | Zip Code | County | ||
| SUNRISE | FL | 33323 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HAZ 1040025381-15 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Other | ARNP | ||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ARNP1328592 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Broward | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| MEMORIAL REGIONAL HOSPITAL(HOLLYWOOD) | 100038 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/22/2017 | 5/31/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| ELECTIVE ESOPHAGOGASTRECTOMY | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| ELECTIVE ESOPHAGOGASTRECTOMY | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| ALLEGED FAILURE TO TURN ON VENTILATOR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| ARREST, HYPOXIC BRAIN INJURY AND DEATH. | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 5/17/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Settlement Reached Prior to Pre-Suit Period | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 5/17/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $580,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $16,525 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $3,749 | ||||||||||||||||||||
| 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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. NORMAN SHEPPLE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NORMAN SHEPPLE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).