| Department File Number : | M201782090 |
| Claim Number : | 156919 |
| Date Submitted : | 5/12/2017 |
| 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 | Dionysia | Lawson | |||
| Street Address | |||||
| 560 Davis Street | |||||
| City | State | Zip | |||
| San Francisco | CA | 94111 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (415) 735 - 2013 | (415) 735 - 2097 | dlawson@norcalmutual.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Bao-Chau | Huynh | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 3175 Citrus Tower Blvd | ||||
| City | State | Zip Code | County | ||
| Clermont | FL | 34711 | Lafayette | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MS000913 | $500,000 | $1,500,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME101771 | Internal Medicine - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Lake | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Emergency Room | |||||
| Name of Institution | Code | ||||
| HEART OF FLORIDA REGIONAL MEDICAL CENTER | 100137 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | Emergency Room | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/18/2014 | 6/22/2016 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Chest pains post vehicle accident | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Respiratory consultation | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| Alleged missed Pulmonary embolus | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Alleged missed Pulmonary embolus | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 11/4/2016 | 2016-CA-003566 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Polk | 3/7/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Mathan, Sukumar Heart of FL Regional Med Ctr | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Claim or suit abandoned. | |||||
| Final Method of Claim Disposition | |||||
| Dropped before Action Filed | |||||
| Court Decision | Other | ||||
| Other | No complaint file/ claim abandoned | ||||
| 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 | $8,261 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Discussed with Risk Mgt and Insured | |||||||||||||||||||||
| Updates | |
| No updates found. |
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Does Dr. BAO-CHAU HUYNH, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. BAO-CHAU HUYNH, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).