Department File Number : | M201574068 |
Claim Number : | 0307228 |
Date Submitted : | 8/28/2017 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | PANTHIPA | LAOWANSIRI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 910 Old Camp Road, Suite 130 | ||||
City | State | Zip Code | County | ||
The Villages | FL | 32162 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-CL-106642 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME111833 | Infectious Diseases - 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 | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
LEESBURG REGIONAL MEDICAL CENTER | 100084 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/19/2012 | 6/4/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient presented with severe abdominal pain and later diagnosed with colitis, pancytopenia and sepsis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Infectious disease consultation while patient was in the ER. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Disputed allegations of failing to ensure hospital nurses hung the ordered antibiotics resulting in sepsis and death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
12/22/2014 | 2013CA 002636 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Lake | 8/23/2017 | ||||
Other Defendants Involved in this Claim | |||||
Leesburg Regional Medial Center Narain, Shaki Phoenix Physicians, LLC Phoenix Emergency Services of Leesburg, LLC Shakti Narain, MD, PA Tri-Country Infectious Disease Consultants, LLC Ricks, John | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
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 | $105,157 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $42,917 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Patient presented with severe abdominal pain and later diagnosed with colitis, pancytopenia and sepsis. |
Updates | ||||||||||||||||||||||||||||||||||||||||
Date of Change: | 8/28/2017 3:17:51 PM | |||||||||||||||||||||||||||||||||||||||
Reason for Change: | File was Reopened 6/23/2015. | |||||||||||||||||||||||||||||||||||||||
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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.
Department File Number : | M201678046 |
Claim Number : | 330577 |
Date Submitted : | 4/26/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
DOCTORS COMPANY, AN INTERINSURANCE EXCHANGE (THE) | Primary | ||||
Insurer FEIN | Professional License Number | ||||
95-3014772 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kelly | Andrews | |||
Street Address | |||||
12724 Gran Bay Parkway, W., Suite 400 | |||||
City | State | Zip | |||
Jacksonville | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 360 - 3038 | kandrews@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Panthipa | Laowansiri | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 7750 East Misty Lane | ||||
City | State | Zip Code | County | ||
Inverness | FL | 34450 | Lake | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0954044 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME111833 | Infectious Diseases - Minor 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 | ||||
Other Hospital/Institution | The Villages Regional Hospital | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/30/2013 | 5/27/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient¿s culture was positive for Candida Albicans and was ultimately diagnosed with diverticular abscess. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Infectious disease consultation following failed oral antibiotics. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Disputed allegations of failing to discontinue Levofloxacin after the patient developed extremity pain. | |||||
Principal Injury Giving Rise To The Claim | |||||
Alleged numbness, painful paresthesia and peripheral neuropathy in both upper extremities. | |||||
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 | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 4/18/2016 | ||||
Other Defendants Involved in this Claim | |||||
Crystal, Maria | |||||
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 | |||||
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 | $7,405 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $15,616 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
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. PANTHIPA LAOWANSIRI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PANTHIPA LAOWANSIRI, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).