| Department File Number : | M201990061 |
| Claim Number : | 164510-2 |
| Date Submitted : | 9/25/2019 |
| 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 | Christina | J | Stoker | ||
| Street Address | |||||
| 1100 Dr. Martin Luther King Jr. Blvd, Ste. 500 | |||||
| City | State | Zip | |||
| Nashville | TN | 37203 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (615) 344 - 1779 | (866) 715 - 7235 | christina.stoker@hcahealthcare.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | OWEN | R | KIERAN | ||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 325 CYPRESS PARKWAY STE 200 | ||||
| City | State | Zip Code | County | ||
| KISSIMMEE | FL | 34758 | Osceola | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| HCI-10118 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Osteopathic Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| OS14242 | Surgery - General | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Osceola | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Other Location | MEDICAL SPECIALTY GROUP AT POINCIANA | ||||
| Name of Institution | Code | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Other | PATHOLOGY | ||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 3/14/2018 | 4/17/2018 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| PRESENTED FOR BREAST CANCER ISSUES. | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| UNDERWENT BIOPSY OF TWO LESIONS IN RIGHT BREAST. | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| *NR | |||||
| Principal Injury Giving Rise To The Claim | |||||
| PARTIAL MASTECTOMY OF WRONG BREAST MASS. | |||||
| 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 | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 8/29/2019 | ||||
| Other Defendants Involved in this Claim | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Settlement Reached Prior to Pre-Suit Period | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 8/8/2019 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $100,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $3,081 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $22 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $87,500 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| REFERRED TO RISK MANAGEMENT. | |||||||||||||||||||||
| Updates | |
| No updates found. |
Does Dr. OWEN R KIERAN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. OWEN R KIERAN, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).