| Department File Number : | M201575443 |
| Claim Number : | 1020460 |
| Date Submitted : | 9/2/2015 |
| 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 | Myra | J | Lasssen | ||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Fort Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0340 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Ronald | M | Stengel | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 100 S Ashley Dr | ||||
| City | State | Zip Code | County | ||
| Tampa | FL | 33602 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HN006099 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Osteopathic Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| OS4570 | Radiology - theraputic - no surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Collier | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| PHYSICIANS REGIONAL MEDICAL CENTER - COLLIER BOULEVARD | 23960057 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Radiology, Emergency Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 11/4/2011 | 7/28/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Pregnancy | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Reading of transvaginal ultrasound at 9 weeks gestation | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Failure to diagnose placenta previa | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Death | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 11/25/2014 | 11-2014-CA-002376-1 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Collier | 5/27/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| Trainer, MD, Angela Caritas Obstetrics & Gynecology of Naples PLLC Naples Radiologists PA Lim, MD, James S Smock, MD, David E Theobald, MD, Michael R Sarangi, MD, Shamit Physicians Regional Medical Center Florida Imaging Associates, PL Lang, MD, Joseph F Island Obstetrics & Gynecology | |||||
| 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 | |||||
| Disposed of by Court | |||||
| Court Decision | Other | ||||
| Summary judgment for the defendant. | |||||
| 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 | $43,128 | ||||||||||||||||||||
| 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 | |||||||
| Date of Change: | 9/2/2015 7:27:41 AM | ||||||
| Reason for Change: | Update issue company | ||||||
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Does Dr. RONALD M STENGEL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. RONALD M STENGEL, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).