Department File Number : | M201886583 |
Claim Number : | 6012088 |
Date Submitted : | 9/28/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
OMS NATIONAL INSURANCE COMPANY, RISK RETENTION GROUP | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-3571664 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Romelia | Alvarez | |||
Street Address | |||||
6133 North River Road, Suite 650 | |||||
City | State | Zip | |||
Rosemont | IL | 60018 | |||
Phone | Ext | Fax | E-Mail Address | ||
(847) 653 - 8823 | Romelia.Alvarez@fortressins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Stephen | C | Morris | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 7011 Cypress Ter Suite 101 | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33907 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
21508 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN10351 | Oral and Maxillofacial Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Lee | ||||
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 | ||||
8/1/2014 | 11/21/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient was referred to Dr. Morris for extraction of 3rd molars. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The planned procedure was extraction of teeth #1, 16, 17 and 32. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The allegation was that Dr. Morris extracted tooth #31 instead of tooth #32 which in turn required additional orthodontic treatment. | |||||
Severity Of Injury | |||||
Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
3/25/2016 | 16-CA-003733 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lee | 9/12/2018 | ||||
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 | |||||
9/28/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $45,001 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $49,088 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $375 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Documentation. |
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.
Department File Number : | M201574438 |
Claim Number : | 6012199 |
Date Submitted : | 4/30/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
OMS NATIONAL INSURANCE COMPANY, RISK RETENTION GROUP | Primary | ||||
Insurer FEIN | Professional License Number | ||||
36-3571664 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Janet | L | Meyer | ||
Street Address | |||||
6133 North River Road, Suite 650 | |||||
City | State | Zip | |||
Rosemont | IL | 60018 | |||
Phone | Ext | Fax | E-Mail Address | ||
(847) 653 - 8823 | (847) 653 - 8485 | janet.meyer@fortressins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Stephen | C | Morris | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 7011 Cypress Terrace, Suite 101 | ||||
City | State | Zip Code | County | ||
Fort Myers | FL | 33912 | Lee | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
21508 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Dentistry | |||||
License Number | Specialty Code & Classification | Certification Number | |||
DN10351 | Dentists - Engaged in oral surgery or operative dentistry on patients rendered unconscious through the administering of any anesthesia or analgesia |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Lee | ||||
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 | ||||
10/24/2014 | 12/30/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient presented for the extraction of teeth in preparation for an anchored upper denture. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
The insured extracted the agreed upon teeth and also extracted posts at site #'s 6 and 11. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
The patient alleges the insured wrongfully extracted the posts at site #'s 6 and 11, these posts were to anchor the upper denture post extractions. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 4/17/2015 | ||||
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 | |||||
4/20/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $30,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
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. STEPHEN C MORRIS, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. STEPHEN C MORRIS, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).