| Department File Number : | M201885948 |
| Claim Number : | 59276101 |
| Date Submitted : | 7/17/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PHYSICIANS INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 13-4235490 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Renee | M | Silvia | ||
| Street Address | |||||
| 901 S. Mopac Expwy, Blg. 5, Suite 500 | |||||
| City | State | Zip | |||
| Austin | TX | 78746 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (512) 425 - 5924 | (512) 328 - 8067 | renee-silvia@tmlt.org | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Robert | S | Davidson | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1840 Mease Street, Suite 301 | ||||
| City | State | Zip Code | County | ||
| Safety Harbor | FL | 34695 | Pinellas | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 144752 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME85644 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Pinellas | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| SAFETY HARBOR SURGERY CENTER LLC | 14960749 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/26/2016 | 10/3/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| The patient had complaints related to cholelithiasis. She complained of severe pain in her back and upper abdomen. Ultrasound revealed sludge and gallstones. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| The patient underwent a laparoscopic cholecystectomy and marked fibrosis and scarring were noted during the procedure. A fourth port was placed to increase with visualization. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Post-operatively, the patient complained of pain and she experienced jaundicing. Various tests were ordered, which revealed an elevated bilirubin and an ERCP was done. The patient was found to have a common bile duct injury. | |||||
| 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 | ||||
| 11/20/2017 | 17-006893-CI | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Pinellas | 6/12/2018 | ||||
| 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 | |||||
| 7/9/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $10,329 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $9,909 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Not applicable. | |||||||||||||||||||||
| Updates | |
| No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ROBERT S DAVIDSON, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ROBERT S DAVIDSON, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).