Department File Number : | M201576354 |
Claim Number : | 2274148 |
Date Submitted : | 11/18/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
THE CINCINNATI INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
31-0542366 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Heather | N | Hartman | ||
Street Address | |||||
6200 South Gilmore Road | |||||
City | State | Zip | |||
Fairfield | OH | 45014 | |||
Phone | Ext | Fax | E-Mail Address | ||
(513) 603 - 5846 | (513) 371 - 7028 | Heather_Hartman@CINFIN.COm |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Augusto | A | Conte | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 665 W Lumsden Rd | ||||
City | State | Zip Code | County | ||
Brandon | FL | 33511 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
CAP 5076719 | $500,000 | $1,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN12588 | Dentists |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
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 | ||||
6/17/2014 | 7/30/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Insd extracted molar #32, advised patient of risks & had her sign consent form. He advised her of possible temp or permanent paraesthesia of the lingual nerve. Clmt returned complaining of this, then went to oral surgeon at insd request. Surgeon opined that insd cut the lingual nerve. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Insd extracted molar #32, advised patient of risks & had her sign consent form. He advised her of possible temp or permanent paraesthesia of the lingual nerve. Clmt returned complaining of this, then went to oral surgeon at insd request. Surgeon opined that insd cut the lingual nerve. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Insd extracted molar #32, advised patient of risks & had her sign consent form. He advised her of possible temp or permanent paraesthesia of the lingual nerve. Clmt returned complaining of this, then went to oral surgeon at insd request. Surgeon opined that insd cut the lingual nerve. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 11/17/2015 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
None given |
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. AUGUSTO A CONTE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. AUGUSTO A CONTE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).