Department File Number : | M202093278 |
Claim Number : | NEWSPC000259023 |
Date Submitted : | 8/14/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
LIBERTY INSURANCE UNDERWRITERS INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
22-2227331 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Julie | Hamilton | |||
Street Address | |||||
220 E. Central Parkway, Suite 2070 | |||||
City | State | Zip | |||
Altamonte Springs | FL | 32701 | |||
Phone | Ext | Fax | E-Mail Address | ||
(321) 972 - 0121 | juliehamilton@hamlinandburton.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tracey | L | Pounds | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 600 E. Dixie Avenue | ||||
City | State | Zip Code | County | ||
Leesburg | FL | 34748 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
AHY934571001 | $1,000,000 | $6,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Registered Nurse | |||||
License Number | Specialty Code & Classification | Certification Number | |||
RN9457695 | General Preventative Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lake | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
LEESBURG REGIONAL MEDICAL CENTER | 100084 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/10/2019 | 3/9/2020 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Work-up of potential DVT¿s | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Forceful removal of Foley catheter | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis | |||||
Principal Injury Giving Rise To The Claim | |||||
Urethral and prostatic injury resulting in hemorrhage | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/19/2020 | ||||
Other Defendants Involved in this Claim | |||||
Leesburg Regional Medical Center | |||||
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 | |||||
7/7/2020 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $280,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $2,530 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $277,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Unknown. This is the responsibility of the employer. |
Updates | |
No updates found. |
Does Dr. TRACEY L POUNDS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. TRACEY L POUNDS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).