| Department File Number : | M201884382 |
| Claim Number : | JY013J0435567 |
| Date Submitted : | 2/21/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| ACE AMERICAN INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 95-2371728 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | John | A | Crist DPM | ||
| Street Address | |||||
| 1130 creekside parkway #111324 | |||||
| City | State | Zip | |||
| Naples | FL | 34108 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (239) 272 - 1185 | (718) 732 - 2063 | naplesfootdoctor@gmail.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | John | A | Crist | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1130 creekside Parkway #111324 | ||||
| City | State | Zip Code | County | ||
| Naples | FL | 34108 | Collier | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 808891 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Podiatric Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PO1768 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Collier | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| PHYSICIANS REGIONAL MEDICAL CENTER - COLLIER BOULEVARD | 23960057 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/15/2012 | 2/24/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Bunion bilateral, tailors bunion bilateral, Hammer toe 2nd toe bilateral, deformity metatarsal bilateral, Achilles Equinus left | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| calcaneal osteotomy with fixation with staple of left foot with modified McBride bunionectomy of left great 1st MPJ and Lapidus fusion of the 1st metatarsal base and medial cuneiform joint along with an Achilles¿ tendon lengthening,Hammertoe operation of the 2nd digit with arthrodesis with smart toe implant and a Tailor¿s bunionectomy with 5th metatarsal osteotomy with fixation | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis was asserted | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Failure of fixation left foot | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 6/5/2015 | 2015CA0006502 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Collier | 7/17/2017 | ||||
| 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 | |||||
| 5/9/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $58,564 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $1 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Updates | |
| No updates found. |
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| Department File Number : | M201988270 |
| Claim Number : | JY13J0435567 |
| Date Submitted : | 3/25/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| CHUBB NATIONAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 22-3253301 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Kylie | Kilgannon | |||
| Street Address | |||||
| 10 Exchange Place | |||||
| City | State | Zip | |||
| Jersey City | NJ | 07302 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (201) 356 - 5171 | kylie.kilgannon@chubb.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | John | Crist | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 6101 Pine Ridge Road, 3rd Floor | ||||
| City | State | Zip Code | County | ||
| Naples | FL | 34119 | Collier | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| CLR 674779 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Podiatric Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PO1768 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Collier | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Physician's Office | |||||
| Name of Institution | Code | ||||
| N/A | 000000 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/9/2012 | 8/22/2013 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Bunions | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Bunionectomy | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Patient alleged negligent surgery requiring 3 subsequent surgeries including a fusion | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Surgery/ bunions | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 4/10/2015 | 2015-CA-0006-652 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Collier | 4/28/2017 | ||||
| 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 | |||||
| 4/28/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $86,717 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Unknown | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. JOHN A CRIST, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN A CRIST, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).