Department File Number : | M201576344 |
Claim Number : | 150603-2 |
Date Submitted : | 12/10/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kenneth | Hagan | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3627 University Blvd. S | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32216 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10113 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61915 | Physicians or Surgeons - Major Surgery. NOC classification. | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MEMORIAL HOSPITAL JACKSONVILLE | 100179 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
10/19/2013 | 10/22/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Cholelithiasis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent laparoscopic cholecystectomy for sludge in gallbladder status post laparoscopic vertical sleeve gastrectomy. Patient had signs of hemorrhaging post operatively and was taken back for emergency exploratory laparotomy for clot removal. Patient deteriorated in ICU and expired. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 11/10/2015 | ||||
Other Defendants Involved in this Claim | |||||
Salenga, M.D., Joseph | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After arbitration is initiated or prior to suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
10/30/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $992,500 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $40,270 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $7,915 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $592,500 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of policies and procedures. |
Updates | ||||||||||||||||
Date of Change: | 12/10/2015 12:34:58 PM | |||||||||||||||
Reason for Change: | Additional LAE payments made. | |||||||||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201676787 |
Claim Number : | 153987-2 |
Date Submitted : | 11/28/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kenneth | Hagan | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3627 University Blvd. S Suite 700 | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32216 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10114 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61915 | Surgery - Abdominal | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MEMORIAL HOSPITAL JACKSONVILLE | 100179 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
11/4/2014 | 12/29/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Cholecystitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent laparoscopic cholecystectomy with intraoperative cholangiogram. Patient had cardiac arrest three days after discharge & expired. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
*NR | |||||
County Suit Filed in | Date of Final Disposition | ||||
*NR | 12/23/2015 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
After arbitration is initiated or prior to suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/22/2015 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $800,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $11,882 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $7,987 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $500,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Review of policies and procedures. |
Updates | |||||||
Date of Change: | 11/28/2016 3:13:51 PM | ||||||
Reason for Change: | Additional LAE payments made. | ||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
Medical Malpractice Closed Claims Report
*NR:Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information. |
Department File Number : | M201782997 |
Claim Number : | 155640 |
Date Submitted : | 7/26/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | KENNETH | HAGAN | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3599 UNIVERSITY BLVD. SOUTH STE 909 | ||||
City | State | Zip Code | County | ||
JACKSONVILLE | FL | 32216 | Dade | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10112 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61915 | Gastroenterology - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Gulf | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Other Hospital/Institution | FL DEPT CORRECTIONS RECEPTION & MED CTR | ||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
9/4/2012 | 7/7/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Bilateral inguinal hernias. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Allege failure to treat timely & adequately patient's complaints of varicocele following hernia surgery. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Loss of right testicle. | |||||
Severity Of Injury | |||||
Permanent: Minor - Loss of fingers, loss or damage to organs. Includes non-disabling injuries. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
6/11/2015 | 3:15-CV-703-J-34MCR | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 7/26/2018 | ||||
Other Defendants Involved in this Claim | |||||
NIELDS, M.D., WILLIAM | |||||
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 subject to arbitration, but settlement reached in lieu of award. | |||||
Date of Payment | |||||
8/23/2017 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $8,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $16,857 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $3,655 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $6,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
REINFORCEMENT OF POLICY AND PROCEDURE. |
Updates | |||||||||||||||||||||||||||||||||||||
Date of Change: | 7/26/2018 1:05:50 PM | ||||||||||||||||||||||||||||||||||||
Reason for Change: | ADDITIONAL LAE PAYMENTS MADE. | ||||||||||||||||||||||||||||||||||||
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*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201575725 |
Claim Number : | 152159-2 |
Date Submitted : | 8/1/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
HEALTH CARE INDEMNITY, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
61-0904881 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Teresa | Ross | |||
Street Address | |||||
One Park Plaza P.O. Box 555 | |||||
City | State | Zip | |||
Nashville | TN | 37202 | |||
Phone | Ext | Fax | E-Mail Address | ||
(615) 344 - 5804 | Teresa.Ross@HCAHealthcare.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Kenneth | Hagan | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 3627 University Blvd. S Suite 700 | ||||
City | State | Zip Code | County | ||
Jacksonville | FL | 32216 | Duval | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10112 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME61915 | Surgery - General | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Duval | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
MEMORIAL HOSPITAL JACKSONVILLE | 100179 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
2/10/2012 | 5/8/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Cholelithiasis with cholecystitis. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient underwent laparoscopic cholecystectomy on 2/9/12. Allege failure to recognize acute blood loss shock & appropratiely treat patient. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Death - acute blood loss. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
1/27/2015 | 16-2015-CA-000460 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Duval | 8/26/2015 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Claim or suit abandoned. | |||||
Final Method of Claim Disposition | |||||
Disposed of by Court | |||||
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 | $4,290 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $815 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Review of policies and procedures. |
Updates | |||||||
Date of Change: | 8/1/2016 2:27:31 PM | ||||||
Reason for Change: | Additional LAE payments made. | ||||||
|
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. KENNETH HAGAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. KENNETH HAGAN, MD has at least 5 medical malpractice case(s), lawsuit(s), or complaint(s).