| Department File Number : | M201988112 |
| Claim Number : | WC/110020-17 |
| Date Submitted : | 3/8/2019 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| Watson Clinic LLP | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 59-070493 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Diane | Szymanski | |||
| Street Address | |||||
| 1600 Lakeland Hills Blvd | |||||
| City | State | Zip | |||
| Lakeland | FL | 33809 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (863) 680 - 7620 | (863) 616 - 2430 | aszymanski@watsonclinic.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Tri | M | Pham | ||
| Insurer Type | Street Address of Practice | ||||
| Self-Insurer | 1600 Lakeland Hills Blvd | ||||
| City | State | Zip Code | County | ||
| Lakeland | FL | 33805 | Polk | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| PH1605501-PL | $2,000,000 | $18,000,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Medical Doctor | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| ME98811 | Infectious Diseases - No Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| M | Polk | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| BARTOW MEMORIAL HOSPITAL | 100121 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Patients' Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 2/28/2016 | 6/19/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| 3/4/2016 at Bartow Regional Medical Center - acute gastroenteritis with significant dehydration and acute kidney injury.3/6/2016 at Lakeland Regional Medial Center - Methicillin-susceptible Staphylococcus aureus (MSSA). | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| 52 year old male was seen at Bartow Regional Medical Center 2/28/2016 through 3/4/2016 for suspected gastroenteritis. An extensive work-up was completed for bacterial infection and colitis including C-diff. Cytomegalovirus antibody, Epstein-Barr virus antibody, HIV antibodies, urine and stool studies as well as blood cultures - which were all negative - were completed. An unremarkable CT of the abdomen/pelvis was done. Mr. Rivera was discharged with a diagnosis of acute viral gastroenteritis, significant dehydration and acute kidney injury that all resolved while in the hospital.The patient presented to Lakeland Regional Medical Center on 3/6/2016 due to recurrence of fever. A blood culture was obtained on admission which was positive for methicillin-susceptible staphylococcus aureus. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| This claim is not believed to involve a misdiagnosis. | |||||
| Principal Injury Giving Rise To The Claim | |||||
| The Plaintiff's Counsel alleges that the patient was inadequately and improperly assessed with a fever of unknown origin. That he was misdiagnosed with a viral infection, discontinued antibiotic therapy and prematurely discharged despite the signs and symptoms of an ongoing bacterial infection.Based upon the patient's presentation to Bartow Regional Medical Center he did not meet the definition of fever of unknown origin. Both he and his wife had been sick during the flu season. As such the working diagnosis of viral illness was appropriate at that time. | |||||
| 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 | ||||
| 2/26/2018 | 2018CA-000533-0000 | ||||
| County Suit Filed in | Date of Final Disposition | ||||
| Polk | 2/11/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Bartow Regional Medical Center Philip, MD, Rengit Shah, MD, Darshan B Belal, MD, Farouk Advanced Care Hospitalists, PL Cypress Cardiology, PA | |||||
| 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 | |||||
| 2/11/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $60,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $31,321 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $4,273 | ||||||||||||||||||||
| 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 | |||||||||||||||||||||
| Circumstances of the event were reviewed with individual parties involved. | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. TRI M PHAM, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. TRI M PHAM, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).