Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Department File Number : | M201885367 |
| Claim Number : | 7031139 |
| Date Submitted : | 5/23/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| FORTRESS INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 36-4159841 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Florence | R | Marafatsos | ||
| Street Address | |||||
| 6133 N River Road Ste 650 | |||||
| City | State | Zip | |||
| Rosemont | IL | 60018 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (800) 522 - 6675 | 8466 | (847) 653 - 8486 | florence.marafatsos@fortressins.com | ||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | MICHAEL | A | GORMAN | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 4440 W Seneca Ave | ||||
| City | State | Zip Code | County | ||
| Weston | FL | 33332 | Broward | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 3006061 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Dentistry | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| DN16349 | Oral and Maxillofacial Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Broward | ||||
| 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 | ||||
| 2/10/2015 | 8/29/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Patient presented for crowns to be placed upon teeth #2, #3, #4, #13, #14, #15, #19 and #30. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| All eight teeth were prepared and placement of the eight crowns was completed. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The patient alleged she had multiple ill-fitting crowns, incorrectly performed root canals related to an overextended fill upon tooth #19 and a broken instrument in tooth #2 and had to have the eight crowns replaced again by a prosthodontist. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 10/4/2017 | 62377451 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Broward | 4/27/2018 | ||||
| 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 | |||||
| 4/27/2018 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $34,167 | ||||||||||||||||||||
| 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. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. MICHAEL A GORMAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MICHAEL A GORMAN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).