Department File Number : | M201472422 |
Claim Number : | 1005598 |
Date Submitted : | 10/22/2014 |
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 | Virginia | A | McIntosh | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 6123 NW 120th Terrace | ||||
City | State | Zip Code | County | ||
Coral Springs | FL | 33076 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
92RKB100996 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME60356 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
5/18/2000 | 9/2/2009 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Presented with complaints of lower extremity weakness and pain. History of autoimmune disease and allergy to shellfish. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Referred to rheumatologist for abdominal and pelvic CT scan. Exam, vitals and ordered CBC when patient returned with blood in urine a few days after scan. Advised to go to nearest emergency room. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged failure to timely refer to ER. | |||||
Principal Injury Giving Rise To The Claim | |||||
Sepsis and death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/18/2009 | 09-62596 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 9/23/2014 | ||||
Other Defendants Involved in this Claim | |||||
Cunningham & Raskin, Inc. Rosensweig, Robert A | |||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/11/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $111,259 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $56,711 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $125,000 | ||||||||||||||||||||
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. |
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Does Dr. VIRGINIA A MCINTOSH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. VIRGINIA A MCINTOSH, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).