Department File Number : | M201679673 |
Claim Number : | 1014968-03 |
Date Submitted : | 9/9/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL FIRE & MARINE INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
47-6021331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Pamela | A | Prudlow | ||
Street Address | |||||
5814 Reed Road | |||||
City | State | Zip | |||
Ft. Wayne | IN | 46835 | |||
Phone | Ext | Fax | E-Mail Address | ||
(260) 486 - 0370 | (260) 486 - 0785 | pamela.prudlow@medpro.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Richard | C | Brown | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 701 Sixth Street South | ||||
City | State | Zip Code | County | ||
Saint Petersburg | FL | 33701 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HN006333 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Osteopathic Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS12205 | Surgery - Obstetrics - Gynecology |
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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
BAYFRONT MEDICAL CENTER | 100032 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Labor and Delivery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
12/28/2010 | 3/30/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Pregnancy. Induction of labor & delivery. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Vacuum delivery. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to properly use vacuum in light of pop offs and excessive force in delivery. | |||||
Principal Injury Giving Rise To The Claim | |||||
Shoulder dystocia and brachial plexus injury. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 8/9/2016 | ||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
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 | $14,427 | ||||||||||||||||||||
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 | |||||||||||||||||||||
n/a |
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. RICHARD C BROWN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RICHARD C BROWN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).