Department File Number : | M201988351 |
Claim Number : | CLW0002292 |
Date Submitted : | 4/1/2019 |
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 | Diane | M | McNab | ||
Street Address | |||||
9372 Lake Serena Drive | |||||
City | State | Zip | |||
Boca Raton | FL | 33496 | |||
Phone | Ext | Fax | E-Mail Address | ||
(954) 439 - 0580 | dmcnab@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Nicholas | Sama | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 10111 Forest Hill Blvd. Rm 151 | ||||
City | State | Zip Code | County | ||
Wellington | FL | 33414 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
725280N | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME91084 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Palm Beach | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WELLINGTON REGIONAL MEDICAL CENTER | 110010 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/16/2016 | 8/29/2018 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient was post core decompression of the left hip. The patient presented to this provider's office with complaints of left groin and hip pain. MRI of left hip reflected avascular necrosis of the left hip. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The patient underwent a total left hip arthroplasty. The patient alleged it was improperly performed requiring additional surgery. This was highly disputed with expert support. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis. | |||||
Principal Injury Giving Rise To The Claim | |||||
Left hip pain and the need for additional surgery. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/19/2018 | 502018CA0151184 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Palm Beach | 3/15/2019 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
2/14/2019 |
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 | $10,262 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $10,262 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured met and conferenced with defense attorney and claims specialist |
Updates | |
No updates found. |
Does Dr. NICHOLAS SAMA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NICHOLAS SAMA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).