Department File Number : | M201782819 |
Claim Number : | F14-0037-A-11 |
Date Submitted : | 8/14/2017 |
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 | NGOC | NGUYEN | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 6158 9th Ave Cir NE | ||||
City | State | Zip Code | County | ||
Bradenton | FL | 34212 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MS000975 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME67875 | Anesthesiology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Manatee | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Outpatient Facility | ||||
Name of Institution | Code | ||||
CENTER FOR SPECIAL SURGERY | 244 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/16/2011 | 2/19/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Arthroscopic surgery of right elbow | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Right interscalene block | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Failed to recognize paralysis of left hemidiaphragm | |||||
Principal Injury Giving Rise To The Claim | |||||
Respiratory failure | |||||
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 | ||||
9/12/2014 | 14-005241-CI | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 6/27/2017 | ||||
Other Defendants Involved in this Claim | |||||
Laroque, Grant Center for Special Surgery Gulcoast Anesthesia Partners Rodriguez, Jorge | |||||
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 | |||||
7/18/2017 |
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 | $0 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $74,398 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Case discussed with insured. Risk management will contact if necessary |
Updates | |
No updates found. |
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Does Dr. NGOC NGUYEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. NGOC NGUYEN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).