| Department File Number : | M202091389 |
| Claim Number : | 1062467-01 |
| Date Submitted : | 4/6/2020 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| MEDICAL PROTECTIVE COMPANY (THE) | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 35-0506406 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Lynn | Louthan | |||
| Street Address | |||||
| 5814 Reed Road | |||||
| City | State | Zip | |||
| Ft Wayne | IN | 46835 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (260) 486 - 0778 | reportaclaim@medpro.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Susan | W | Llarena | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1409 Plantation Oaks Ter | ||||
| City | State | Zip Code | County | ||
| Fernandina Beach | FL | 32034 | Nassau | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| F87782 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Other | Physicians Assistant | ||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PA2061 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Nassau | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 1/13/2016 | 6/18/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| recurring urinary tract infections | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| antibiotics for urinary tract infections | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| failing to properly assess, monitor and treat recurring urinary tract infections | |||||
| Principal Injury Giving Rise To The Claim | |||||
| 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 | 1/24/2020 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 1/24/2020 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $175,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $12,954 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $5,226 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $175,000 | ||||||||||||||||||||
| 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. |
Does Dr. SUSAN W LLARENA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SUSAN W LLARENA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).