Department File Number : | M202092596 |
Claim Number : | 71079-A |
Date Submitted : | 5/29/2020 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDMAL DIRECT INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-2813188 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Daniel | J | Dupre | ||
Street Address | |||||
76 South Laura Street Suite 900 | |||||
City | State | Zip | |||
Jacksonville | FL | 32202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 482 - 4067 | ddupre@medmaldirect.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | William | B | Ferguson | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 210 Old Kings Rd. South | ||||
City | State | Zip Code | County | ||
Flagler Beach | FL | 32136 | Flagler | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL707246 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME94793 | Nephrology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Flagler | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Location | Florida Hospital Flagler | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Special Procedure Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/22/2018 | 5/3/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Multiple Myeloma, Acute Renal Failure, Plasma Cell Leukemia | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Dialysis prior to induction of chemotherapy | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
The patient's multiple conditions were correctly diagnosed. | |||||
Principal Injury Giving Rise To The Claim | |||||
A needle intended for the jugular vein nicked the aorta | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 5/26/2020 | ||||
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 | |||||
4/30/2020 |
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 | $10,000 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $1,230 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $248,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured did intensive internal procedure analysis with the hospital to improve patient safety. |
Updates | |
No updates found. |
Does Dr. WILLIAM B FERGUSON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. WILLIAM B FERGUSON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).