Department File Number : | M201575079 |
Claim Number : | SAM-IG-004791 |
Date Submitted : | 7/5/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
SAMARITAN RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3433505 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | NANCY | CARR | |||
Street Address | |||||
11440 SW 88th STREET | |||||
City | State | Zip | |||
MIAMI | FL | 33176 | |||
Phone | Ext | Fax | E-Mail Address | ||
(305) 274 - 4070 | (305) 274 - 2701 | carol.lobacz@nccrms.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | THOMAS | SAN GIOVANNI | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1150 Campo Sano Avenue | ||||
City | State | Zip Code | County | ||
Coral Gables | FL | 33133 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
SPL 1032 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME77754 | Surgery - Orthopedic |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
HEALTHSOUTH DOCTORS' HOSPITAL | 100020 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
8/27/2010 | 11/29/2010 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Severe hallux rigidus deformity with severe arthand, left fifth two bunionette. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Not applicable. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
There was no misdiagnosis made of this patient. | |||||
Principal Injury Giving Rise To The Claim | |||||
The plaintiff underwent elective right foot first metatarsal phalangeal joint head resurfacing. She alleged the flexor halluces longus tendon was but during the surgery and not recognized resulting in right foot pain and aggravation of a pre-existing back condition. These allegations were unsupported by an expert and the lawsuit was voluntarily withdrawn. | |||||
Severity Of Injury | |||||
Temporary: Major - Burns, surgical material left, drug side effect, brain damage. Recovery delayed. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
2/10/2012 | 12-05351 CA 24 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Dade | 5/3/2015 | ||||
Other Defendants Involved in this Claim | |||||
Doctors Hospital | |||||
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 | $234,083 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $35,234 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Not applicable. |
Updates | |
No updates found. |
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Does Dr. THOMAS SAN GIOVANNI, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. THOMAS SAN GIOVANNI, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).