Department File Number : | M201679592 |
Claim Number : | 20046-01 |
Date Submitted : | 9/1/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PODIATRY INSURANCE COMPANY OF AMERICA | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1403235 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Karen | Kessler | |||
Street Address | |||||
3000 Meridian Blvd., Suite 400 | |||||
City | State | Zip | |||
Franklin | TN | 37067 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 371 - 8776 | 2249 | kkessler@picagroup.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Scott | B | Samera | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 404 NW Hall of Fame Dr. | ||||
City | State | Zip Code | County | ||
Lake City | FL | 32055 | Suwannee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
1PD0046329 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Podiatric Physician | |||||
License Number | Specialty Code & Classification | Certification Number | |||
PO3510 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Suwannee | ||||
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 | ||||
2/1/2012 | 10/23/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Diabetic neuropathy; Charcot foot | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Application of Jones compression dressing; CAM Walker dispensed; crutches dispensed | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Pltfs expert alleges that Dr. Samera failed to refer the patient to the appropriate specialist for a complete and comprehensive vascular status work up and evaluation in the presence of a diabetic neuropathy, peripheral vascular disease including absent pedal pulses, and Charcot foot. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/28/2014 | 14-000185CA | ||||
County Suit Filed in | Date of Final Disposition | ||||
Suwannee | 8/31/2016 | ||||
Other Defendants Involved in this Claim | |||||
Scott B. Samera, DPM, P.A. Bienvenido Samera, M.D., P.A. Samera, M.D., Bienvenido Branford Family Medical Center, Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Other | Dismissed w/prejudice | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $91,646 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $21,362 | ||||||||||||||||||||
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 - Specialty code #80993 |
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. SCOTT B SAMERA, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SCOTT B SAMERA, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).