Department File Number : | M201573334 |
Claim Number : | 13-0257-A-11 |
Date Submitted : | 1/11/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
FD INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3704679 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Tamla | Lloyd | |||
Street Address | |||||
4651 Salisbury Road, Suite 410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 296 - 2887 | 212 | (904) 296 - 1245 | tlloyd@fdinsurancecompany.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | John | Coughlin | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 12220 Bruce B. Downs Blvd. | ||||
City | State | Zip Code | County | ||
Tampa | FL | 33612 | Hillsborough | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
10409 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67720 | Surgery - General |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Hillsborough | ||||
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 | Physician's Office | ||||
Date of Occurrence | Date Reported to Insurer | ||||
11/30/2011 | 12/17/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
The patient was presented to the insured with stomach issues. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
This insured performed a gastro-jejunostomy procedure on 11/30/11. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
None made | |||||
Principal Injury Giving Rise To The Claim | |||||
This insured allegedly improperly inserted a GJ tube that caused the leads to an installed gastric stimulator to erode which resulted in infection and removal of a large portion of patient's stomach due to necrotic tissue. | |||||
Severity Of Injury | |||||
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
4/24/2014 | 14-CA-004265 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Hillsborough | 12/30/2014 | ||||
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 | |||||
12/30/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $200,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $37,390 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Circumstances of this case have been discussed with insured and risk management was notified. Risk management has discussed with insured. |
Updates | |||||||
Date of Change: | 1/11/2016 10:20:37 AM | ||||||
Reason for Change: | Updated LAE amount. | ||||||
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Does Dr. JOHN COUGHLIN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. JOHN COUGHLIN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).