Department File Number : | M201990868 |
Claim Number : | 390766 |
Date Submitted : | 12/13/2019 |
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 | Sandra | Y | Vaz | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1033 Martin Luther King Street North | ||||
City | State | Zip Code | County | ||
St. Petersburg | FL | 33701 | Pinellas | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
0919828 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME111248 | Pediatrics - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Outpatient Facility | Advent Health/Florida Hospital for Child | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Critical Care Unit | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/10/2016 | 10/9/2019 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Fresh post-op repair of reherniated bilateral congenital diaphragmatic hernia, post-op hemothorax, longstanding history of pulmonary hypertension. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Provision of non-surgical pediatric intensive care management in conjunction with surgical team. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Cardiac arrest related to post-op hemothorax. Alleged failure to place chest tube in this fresh post-op patient who was co-managed with the surgical team. | |||||
Severity Of Injury | |||||
Permanent: Major - Paraplegia, blindness, loss of two limbs, brain damage. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/11/2019 | ||||
Other Defendants Involved in this Claim | |||||
Thompson, MD, William R Portis, MD, Stephanie Advent Health /Florida Hospital for Children | |||||
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 | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/11/2019 |
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 | $0 | ||||||||||||||||||||
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. |
Does Dr. SANDRA Y VAZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SANDRA Y VAZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).