| Department File Number : | M201884335 |
| Claim Number : | PLFHOR090854 |
| Date Submitted : | 2/14/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Florida Hospital East Orlando | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-1479658 | 4369 | ||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Linda | Boelke | |||
| Street Address | |||||
| 900 Hope Way | |||||
| City | State | Zip | |||
| Altamonte Springs | FL | 32714 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (407) 357 - 1313 | linda.boelke@ahss.org | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Scott | Boone | |||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 601 E. Rollins St | ||||
| City | State | Zip Code | County | ||
| Orlando | FL | 32803 | Orange | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 8258 - 2017 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME40466 | Surgery - Obstetrics - Gynecology | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Orange | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| FLORIDA HOSPITAL (ORLANDO) | 100007 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 7/5/2016 | 4/5/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Uterine prolapse and pelvic relaxation due to pubocervical tissue incompetence. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Total vaginal hysterectomy and cystoscopy. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Involved was the allegation that deviations in the standard of care resulted in patient's second degree partial thickness vulva burns. | |||||
| 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 | 2/7/2018 | ||||
| Other Defendants Involved in this Claim | |||||
| Florida Hospital Orlando | |||||
| 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 | |||||
| 2/7/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $50,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $7,293 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $2,558 | ||||||||||||||||||||
| 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. SCOTT BOONE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SCOTT BOONE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).