Department File Number : | M201782239 |
Claim Number : | F13-0148-A11 |
Date Submitted : | 6/6/2017 |
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 | Paul | Chai | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 601 5TH STREET S 2ND FLOOR, BOX 70-6610 ST | ||||
City | State | Zip Code | County | ||
St. PETERSBURG | FL | 33701 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
MG000741 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME91269 | Surgery - Thoracic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Pinellas | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Nursery | |||||
Date of Occurrence | Date Reported to Insurer | ||||
4/26/2011 | 7/15/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Premature birth, DiGeorge Syndrome | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Aortic arch repair, closure of ventriculoseptal defect, placement of dual-lumen right atrial line via median sternotomy , sternal closure | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death due to complications from DiGeorge Syndrome | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/13/2014 | 13-CA-9263 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Pinellas | 11/29/2016 | ||||
Other Defendants Involved in this Claim | |||||
St. Joseph's Hospital, INC s, Florida Pediatric Associates, LLC Healthpoint Medical Group Chapados, Rene Haffner, JOhn Riggs, Daniel Critchfield, Deanna Grisoni, Enrique | |||||
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 | |||||
Disposed of by Court | |||||
Court Decision | Other | ||||
Summary judgment for the defendant. | |||||
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 | $39,522 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Case discussed with insured, risk management aware and will contact insured if necessary |
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. PAUL CHAI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PAUL CHAI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).