| Department File Number : | M201472070 |
| Claim Number : | 18213-01 |
| Date Submitted : | 9/23/2014 |
| 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 | Timothy | Chan | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 1580 Santa Barbara Blvd. | ||||
| City | State | Zip Code | County | ||
| The Villages | FL | 32159 | Highlands | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| 1PD0041604 | $1,000,000 | $3,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Podiatric Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| PO3400 | |||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Highlands | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Outpatient Facility | Surgical Center at Sun 'n Lake | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 4/11/2011 | 7/3/2012 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Left first MPJ instability; dislocated 2nd, 3rd, and 4th MPJ¿s; hammertoes, digits 2-4; exostosis, 5th toe, all left foot | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Left first MPJ fusion; Weil osteotomy of metatarsals 2-4; arthrodesis of distal and proximal IPJ¿s; arthrodesis of digits 3-5, all left foot | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Patient presented to the insured on 2/21/11 with complaints of a painful, left forefoot. Radiographs showed lateral displacement of the remaining sesamoid, dislocation of the 2nd and 3rd MPJ, and contracture of the lesser toes. Insured¿s exam showed patient had clinically stable vasculature. Patient was also cleared for surgery as low risk by her PCP, and surgery occurred on April 1st. By the second post-op visit on 4/12/11, she presented with a dark, third toe. The fourth toe was also noted to appear dusky, and the patient was referred to a vascular specialist. The patient was admitted to the hospital on 4/14/11 with a presumed infection. She underwent evaluation and intravenous antibiotics. By 4/21/11, insured noted the third and fourth toes were hard and black, and the first and second toes were dusky, yet warm. The incision over the first MPJ was dehisced, and the plate was exposed. Her arteriogram indicated that the blood flow was normal to the trans-metatarsal level, but with no vessels being adequately visualized further distal. Patient underwent amputation of her third and fourth toes on the same date; however, she was advised that ultimately a trans-metatarsal amputation would be best if the ischemic activity did not subside. Patient claims she developed gangrene with subsequent amputation of her toes. She alleges insured failed to perform a pre-op vascular evaluation and that insured¿s surgery further compromised the vascularity. | |||||
| 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 | ||||
| 10/30/2012 | 12-979-GCS | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Highlands | 9/10/2014 | ||||
| Other Defendants Involved in this Claim | |||||
| Foot & Ankle Reconstruction Associates LLC | |||||
| 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 | |||||
| 9/11/2014 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $35,282 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $15,315 | ||||||||||||||||||||
| 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. TIMOTHY CHAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. TIMOTHY CHAN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).