Department File Number : | M201575896 |
Claim Number : | FP4370301 |
Date Submitted : | 9/24/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FIRST PROFESSIONALS INSURANCE COMPANY, INC | Primary | ||||
Insurer FEIN | Professional License Number | ||||
59-6614702 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway W. Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Frank | C | Pettinato | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 3104 W. Waters Avenue, Suite 206B | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33614 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-IN063478 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN8064 | 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 | ||||
Other | Dentist Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
8/10/2011 | 10/23/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient was seen for routine dental visits and it was thought that baby tooth C was permanent tooth #6. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
No procedure rendered. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged misdiagnosis of baby tooth C as permanent tooth #6. | |||||
Principal Injury Giving Rise To The Claim | |||||
Impaction of tooth #6, resulting in need for surgery and orthodontic treatment. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
5/7/2013 | 13CA-005447 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 9/2/2015 | ||||
Other Defendants Involved in this Claim | |||||
Frank C. Pettomato, DDS, PA Pettinato, Tearney | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $49,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $21,235 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $20,965 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
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Does Dr. FRANK C PETTINATO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. FRANK C PETTINATO, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).