Department File Number : | M201987753 |
Claim Number : | HMA67575 |
Date Submitted : | 1/29/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
CONTINENTAL CASUALTY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-2114545 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | SHARI | R | MCGEE | ||
Street Address | |||||
333 S. WABASH AVE. | |||||
City | State | Zip | |||
CHICAGO | IL | 60604 | |||
Phone | Ext | Fax | E-Mail Address | ||
(312) 822 - 2535 | shari.mcgee@cna.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | PETER | S | CHEN | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 835 7th Street Suite 6 | ||||
City | State | Zip Code | County | ||
Clermont | FL | 34711 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
DNC 297135146 | $3,000,000 | $6,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN17794 | Endodondics |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lake | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Special Procedure Room | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Special Procedure Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
3/11/2015 | 9/2/2016 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
ALLEGED ROOT CANAL MATERIAL EXTENDED BEYOND APEX OF TOOTH #31 CAUSING UNDUE PRESSURE ON IAN RESULTING IN PERMANENT NUMBNESS TO RIGHT LOWER LIP AND CHIN. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
ALLEGED ROOT CANAL MATERIAL EXTENDED BEYOND APEX OF TOOTH #31 CAUSING UNDUE PRESSURE ON IAN RESULTING IN PERMANENT NUMBNESS TO RIGHT LOWER LIP AND CHIN. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
ALLEGED ROOT CANAL MATERIAL EXTENDED BEYOND APEX OF TOOTH #31 CAUSING UNDUE PRESSURE ON IAN RESULTING IN PERMANENT NUMBNESS TO RIGHT LOWER LIP AND CHIN. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/21/2017 | 0010707 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Volusia | 1/25/2019 | ||||
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 | |||||
1/25/2019 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $65,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $13,128 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,579 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Enforcing guidelines and policies to prevent risks. |
Updates | |
No updates found. |
Does Dr. PETER S CHEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PETER S CHEN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).