Medical Malpractice Cases

Dr. Charles J Adelson Medical Malpractice Cases

Court Case # 50 2010 CA 9264 MB A

Indemnity Paid: $8,000.00

Medical Malpractice Closed Claims Report

Department File Number :M201160940
Claim Number :HM125049
Date Submitted :7/6/2011
Insurer Information
Insurer NameCoverage Type
Insurer FEINProfessional License Number
Insurer Contact Information
TypeFirst NameMILast Name
IndividualJameela Maddox
Street Address
333 South Wabash Avenue 38th Floor
PhoneExtFaxE-Mail Address
(312) 822 - 5171
Insured Information
TypeFirst NameMILast Name
Insurer TypeStreet Address of Practice
Licensed7737 N University DR STE 207
CityStateZip CodeCounty
Policy NumberPer Claim Policy LimitsAggregate Policy Limits
Profession or BusinessOther Profession or Business
License NumberSpecialty Code & ClassificationCertification Number

Medical Malpractice Closed Claims Report

Injured Person Information
First NameMILast NameDate of Birth
Street AddressGenderCounty where Injury Occurred
CityStateZip Code
Location where injury occuredOther location where injury occured
Physician's Office 
Name of InstitutionCode
Location of Institutional InjuryOther Location of Institutional Injury
Operating Suite 
Date of OccurrenceDate Reported to Insurer
Diagnostic Information
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Alleged that wrong tooth #10 was extracted.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Extraction of two teeth #7 and #9
Diagnostic Code : 
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Principal Injury Giving Rise To The Claim
Alleged insured extractedthe wrong tooth #10 at the direction of Dr Miller, the referring dentist
Severity Of Injury
Permanent: Minor - Loss of fingers, loss or damage to organs.Includes non-disabling injuries.

Medical Malpractice Closed Claims Report


Legal Information
Date of SuitCircuit Court Case Number
11/17/201050 2010 CA 9264 MB A
County Suit Filed inDate of Final Disposition
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 DecisionOther
No Court Proceedings. 
Award for plaintiff.
Date of Payment
Financial Information
Was there a settlement Resulting in payment to the Plaintiff?Yes
Indemnity Paid by Insurer on behalf of Insured$8,000
Loss Adjust Expense Paid to Defense Counsel$30,549
All Other Loss Adjustment Expense Paid$8,355
Injured Person's Total Non-Economic Loss$0
Injured Person's Total Economic Loss
 Incurred to DateAnticipated
Medical Expense$0$0
Wage Loss$0$0
Other Expenses$0$0
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely
claimant will execute a Release with confidentiality and all documents necessary to reassure us that none of his expenses were paid by Medicare
No updates found.



*NR:Prior to 04/28/1999 this field was not required in submitted claims.

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