Department File Number : | M201678058 |
Claim Number : | 209228 |
Date Submitted : | 10/29/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE INDEMNITY COMPANY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
63-0720042 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denise | Stokes | |||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Gilberto | L | Vigo | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1005 Mar Walt Drive | ||||
City | State | Zip Code | County | ||
Fort Walton Beach | FL | 32547 | Okaloosa | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MP83249 | $500,000 | $1,500,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME65239 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Okaloosa | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Physican's office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
1/27/2014 | 12/16/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Intractable migraine headaches | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Medicated with prednisone | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Does not apply | |||||
Principal Injury Giving Rise To The Claim | |||||
Plaintiff alleges prescribing of chronic used steroids for treatment of migraine headaches resulted in bilateral hip necrosis, adrenal insufficiency and osteopenia. | |||||
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 | ||||
1/4/2016 | pre-suit1 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Okaloosa | 4/19/2016 | ||||
Other Defendants Involved in this Claim | |||||
White-Wilson Medical Center, PA | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
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 | |||||
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $500,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,251 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $2,951 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $500,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured discussed care with defense cousel, insurance personnel, and medical experts. |
Updates | ||||||||||||||||||||||
Date of Change: | 5/5/2016 1:26:13 PM | |||||||||||||||||||||
Reason for Change: | Updated Co-defendent info and diagnosis information. | |||||||||||||||||||||
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Date of Change: | 5/12/2016 4:56:02 PM | |||||||||||||||||||||
Reason for Change: | Updated indemnity amount | |||||||||||||||||||||
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Date of Change: | 6/2/2016 2:57:06 PM | |||||||||||||||||||||
Reason for Change: | updated ALAE amoutns | |||||||||||||||||||||
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Date of Change: | 7/8/2016 3:32:11 PM | |||||||||||||||||||||
Reason for Change: | updated ALAE amounts | |||||||||||||||||||||
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Date of Change: | 2/16/2018 12:03:37 PM | |||||||||||||||||||||
Reason for Change: | Updated ALAE information | |||||||||||||||||||||
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Date of Change: | 7/10/2018 1:28:21 PM | |||||||||||||||||||||
Reason for Change: | updated alae | |||||||||||||||||||||
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Date of Change: | 9/26/2018 12:58:09 PM | |||||||||||||||||||||
Reason for Change: | updated alae | |||||||||||||||||||||
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Date of Change: | 10/29/2018 1:17:11 PM | |||||||||||||||||||||
Reason for Change: | updated alae | |||||||||||||||||||||
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This page is not displaying certain sensitive information.
Department File Number : | M201472698 |
Claim Number : | 174829 |
Date Submitted : | 1/14/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
PROASSURANCE CASUALTY COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
38-2317569 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kristy | Hall | |||
Street Address | |||||
100 Brookwood Place | |||||
City | State | Zip | |||
Birmingham | AL | 35209 | |||
Phone | Ext | Fax | E-Mail Address | ||
(205) 802 - 4754 | khall@proassurance.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Gilberto | L | Vigo | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1005 Mar Walt Drive | ||||
City | State | Zip Code | County | ||
Fort Walton Beach | FL | 32547 | Okaloosa | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
ME65239 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME65239 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Okaloosa | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Nursing Home | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/16/2009 | 11/30/2011 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Persistent urinary tract infection | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Administration of Tobramycin intramuscularly | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Patient alleges her stage III renal disease progressed to stage IV renal disease as a result of being given Tobramyacin, causing her to temporarily undergo dialysis. | |||||
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 | ||||
4/16/2012 | 2012 CA 001712 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Okaloosa | 11/12/2014 | ||||
Other Defendants Involved in this Claim | |||||
White-Wilson Medical Center, P.A. Harned, Reed L | |||||
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 | |||||
No Payment Made | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
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 | $10,791 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $5,418 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insured discussed case with defense counsel, insurance personnel, and medical experts. |
Updates | ||||||||||
Date of Change: | 1/14/2015 2:44:20 PM | |||||||||
Reason for Change: | updated financials | |||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. GILBERTO L VIGO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. GILBERTO L VIGO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).