Department File Number : | M201887155 |
Claim Number : | 2017-01335 |
Date Submitted : | 11/28/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CRUDEN BAY RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
27-0057453 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tracy | E | Coleman | ||
Street Address | |||||
10140 Centurion Parkway N | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 697 - 4205 | (904) 697 - 4202 | tcoleman@nemours.org |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | JOHN | E | FERRIS | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8331 North Davis Highway | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 32514 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1111 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
OS10243 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
SACRED HEART HOSPITAL (PENSACOLA) | 100025 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
1/26/2015 | 4/10/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Fracture of radius and ulna of left arm | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Open reduction and intramedullary nail placement | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Transected ulnar nerve | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/17/2017 | 2017CA001056 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Escambia | 8/21/2018 | ||||
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 | |||||
9/30/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $195,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $48,796 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $11,050 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Peer review completed |
Updates | |
No updates found. |
Does Dr. JOHN E FERRIS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN E FERRIS, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).