Department File Number : | M201783377 |
Claim Number : | 160549 |
Date Submitted : | 10/17/2017 |
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 | Susan | Hanson-Leal | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 5301 South Congress Avenue | ||||
City | State | Zip Code | County | ||
Atlantis | FL | 33462 | Palm Beach | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
HCI-10116 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME107227 | Hospitalists | 01 |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Dade | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
COLUMBIA KENDALL MEDICAL CENTER | 100209 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/20/2016 | 2/7/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Acute respiratory failure, STEMI. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Patient to ER on 7/13/16 for STEMI. Patient underwent emergent cardiac catheterization. Post procedure, patient developed severe shortness of breath & transferred to ICU. Patient discharged home on 7/20 with trach collar. Patient returned to ER same evening, 7/20, with shortness of breath. EKG revealed acute lateral infarct. Patient developed difficulty breathing through trach & condition deteriorated. Patient expired. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Cardiac arrest, 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 | 10/12/2017 | ||||
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 | |||||
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 | $24,702 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $9,151 | ||||||||||||||||||||
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 | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. SUSAN HANSON-LEAL, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SUSAN HANSON-LEAL, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).