Department File Number : | M201678748 |
Claim Number : | C160838 |
Date Submitted : | 6/17/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
ADMIRAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
22-2235730 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Angela | Rando | |||
Street Address | |||||
1000 Howard Boulevard Suite 300 | |||||
City | State | Zip | |||
Mount Laurel | NJ | 08054 | |||
Phone | Ext | Fax | E-Mail Address | ||
(856) 857 - 3367 | arando@admiralins.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dai | Nguyen | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6901 SW 7th Terrace | ||||
City | State | Zip Code | County | ||
Miami | FL | 33143 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
EO000019016-003 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME102196 | Family Physicians or General Practitioners - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Outpatient Facility | |||||
Name of Institution | Code | ||||
SOUTH MIAMI HOSPITAL | 100154 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Urgent Care Clinic | ||||
Date of Occurrence | Date Reported to Insurer | ||||
2/8/2014 | 1/15/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
PATIENT COMPLAINED OF SORE THROAT, FEVER OF 101 DEGREES AND EAR ACHE. PATIENT'S ACTUAL CONDITIONWAS MENINGITIS | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
DOCTOR AND NURSE PERRY DISCUSSED AND DIAGNOSED PATIENT WITH AN UPPER RESPIRATORY INFECTION.PATIENT WAS PRESCRIBED ZITHROMAX 205 MG, MAGIC MOUTHWASH, VISCIOUS LIDOCAINE 2% + MAALOX +DIPHENHYDRAMINE AND 600 MG MOTRIN AND DISCHARGED. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
PATIENT WAS DIAGNOSED WITH UPPER RESPIRATORY INFECTION | |||||
Principal Injury Giving Rise To The Claim | |||||
PATIENT HAD MENINGITIS AND DIED | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
9/28/2015 | 15-017808 CA 27 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 3/16/2016 | ||||
Other Defendants Involved in this Claim | |||||
Baptist Health South Florida Baptist Outpatient Service Inc | |||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
3/1/2016 |
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 | $52,029 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,269 | ||||||||||||||||||||
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 | |||||||||||||||||||||
N/A |
Updates | |||||||
Date of Change: | 6/17/2016 3:34:00 PM | ||||||
Reason for Change: | injury location was incorrect | ||||||
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Does Dr. DAI NGUYEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. DAI NGUYEN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).