Department File Number : | M201990640 |
Claim Number : | 7031911 |
Date Submitted : | 11/18/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FORTRESS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-4159841 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Erica | Ames | |||
Street Address | |||||
425 N. Martingale Road | |||||
City | State | Zip | |||
Schaumburg | IL | 60173 | |||
Phone | Ext | Fax | E-Mail Address | ||
(800) 522 - 6675 | 8832 | (847) 653 - 8486 | ERICA.AMES@FORTRESSINS.COM |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Frederick | Kane | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 18999 Biscayne Blvd, Suite 210 | ||||
City | State | Zip Code | County | ||
Aventura | FL | 33180 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
32872 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN11624 | Dental General Practice - NOC |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
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 | ||||
10/7/2016 | 7/20/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was seen on an emergent basis for treatment of infected and hopeless tooth #19. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
On October 7, 2016, after performing an examination of the patient who was seen on an emergent basis, the insured extracted tooth #19 without complication. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged failure to provide post op antibiotics which led to a jaw infection that was ultimately treated by way of a jaw resection and placement of a prosthesis. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
11/10/2017 | 2017-026180-CA-01 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 10/28/2019 | ||||
Other Defendants Involved in this Claim | |||||
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 | |||||
11/11/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $1,000,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $138,798 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
documentation |
Updates | |
No updates found. |
Does Dr. FREDERICK KANE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FREDERICK KANE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).