Department File Number : | M201886313 |
Claim Number : | CLW0001338 |
Date Submitted : | 8/31/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
94-2301054 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Richard | Petersen | |||
Street Address | |||||
4651 Salisbury Rd. #410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 309 - 8142 | (904) 394 - 7134 | rpetersen@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Gerald | Scott | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 187 97th Avenue NE | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33702 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
801245E | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Registered Nurse | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ARNP3292182 | Anesthesiology |
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 | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Recovery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/18/2018 | 3/2/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The plaintiff alleged that she required cosmetic surgery after she injured her teeth while undergoing anesthesia on 01/18/18. In rebuttal, Mr. Scott advised that he believes that the plaintiff involuntarily bit down on the oral airway during recovery and injured her teeth. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The plaintiff alleged that she required cosmetic surgery after she injured her teeth while undergoing anesthesia on 01/18/18. In rebuttal, Mr. Scott advised that he believes that the plaintiff involuntarily bit down on the oral airway during recovery and injured her teeth. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The plaintiff alleged that she required cosmetic surgery after she injured her teeth while undergoing anesthesia on 01/18/18. In rebuttal, Mr. Scott advised that he believes that the plaintiff involuntarily bit down on the oral airway during recovery and injured her teeth. | |||||
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 | 8/10/2018 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Settlement Reached Prior to Pre-Suit Period | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
8/10/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $9,000 | ||||||||||||||||||||
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 | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
The facts of the matter were discussed with insured & risk management. |
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. GERALD SCOTT, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GERALD SCOTT, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).