| Department File Number : | M201575058 |
| Claim Number : | C157133 |
| Date Submitted : | 6/30/2015 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| ADMIRAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 22-2235730 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Diane | M | Pucci | ||
| Street Address | |||||
| 1000 Howard Boulevard | |||||
| City | State | Zip | |||
| Mt. Laurel | NJ | 08054 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (856) 857 - 3375 | (856) 429 - 3630 | dpucci@admiralins.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Thanh | Nguyen | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 19105 US 41 North, Suite 300 | ||||
| City | State | Zip Code | County | ||
| Lutz | FL | 33549 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| EO000013297-04 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME99639 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Outpatient Facility | |||||
| Name of Institution | Code | ||||
| MEMORIAL HOSPITAL - TAMPA | 100206 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/24/2011 | 1/10/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Hernia Repair | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| hernia repair | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| The small hernia was repaired but a femoral hernia was missed and not repaired. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The small hernia was repaired but a femoral hernia was missed and not repaired. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/23/2014 | 14-CA-005236 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 4/24/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| 4/28/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $0 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $75,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| none | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
| Department File Number : | M201679263 |
| Claim Number : | C157133 |
| Date Submitted : | 7/25/2016 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| ADMIRAL INSURANCE COMPANY | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 22-2235730 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Angela | Rando | |||
| Street Address | |||||
| 1000 Howard Boulevard Suite 300 | |||||
| City | State | Zip | |||
| Mount Laurel | NJ | 08054 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (856) 857 - 3367 | arando@admiralins.com | ||||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Thanh | Nguyen | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 19105 US 41 North Suite 300 | ||||
| City | State | Zip Code | County | ||
| Lutz | FL | 33549 | Hillsborough | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| EO000013297-04 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME99639 | Physicians or Surgeons | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Hillsborough | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| MEMORIAL HOSPITAL - TAMPA | 100206 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Operating Suite | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 10/24/2011 | 1/10/2014 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Hernia repair | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| Hernia repair | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| The small hernia was repaired but a femoral hernia was missed and not repaired. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The small hernia was repaired but a femoral hernia was missed and not repaired. | |||||
| Severity Of Injury | |||||
| Temporary: Minor - Infections, misset fracture, fall in hospital. Recovery delayed. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| 5/23/2014 | 14-CA-005236 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Hillsborough | 4/24/2015 | ||||
| Other Defendants Involved in this Claim | |||||
| 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 | |||||
| 4/28/2015 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $75,000 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| N/A | |||||||||||||||||||||
| Updates | |
| No updates found. |
This page is not displaying certain sensitive information.
Does Dr. THANH NGUYEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. THANH NGUYEN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).