Dr. Mason Long Medical Malpractice Cases

Indemnity Paid: $250,000.00

Insurer Information

Insurer Name				Coverage Type
FIRST PROFESSIONALS INSURANCE COMPANY, INC				Primary
Insurer FEIN		Professional License Number
59-6614702
Insurer Contact Information
Type	First Name		MI	Last Name
Individual	Odessa			Choice
Street Address
1000 Riverside Avenue, Suite 800
City				State	Zip
Jacksonville				FL	32204
Phone	Ext	Fax	E-Mail Address
(800) 741 - 3742	3045	(904) 358 - 6728	odessa.choice@fpic.com

Insured Information

Type	First Name		MI	Last Name
Individual	Mason			Long
Insurer Type		Street Address of Practice
Licensed		301 Health Park Blvd., Ste 325
City		State	Zip Code	County
Saint Augustine		FL	32086	St. Johns
Policy Number		Per Claim Policy Limits		Aggregate Policy Limits
19954		$500,000		$1,500,000
Profession or Business			Other Profession or Business
Medical Doctor
License Number		Specialty Code & Classification		Certification Number
ME55529		Internal Medicine - No Surgery		80257

Injured Person Information

First Name	MI	Last Name		Date of Birth

Street Address			Gender	County where Injury Occurred
			M	St. Johns
City			State	Zip Code

Location where injury occured		Other location where injury occured
Physician's Office
Name of Institution		Code

Location of Institutional Injury		Other Location of Institutional Injury

Date of Occurrence		Date Reported to Insurer
5/12/2005		11/21/2005

Diagnostic Information

Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
Urinary frequency and dysuria.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Urinalysis-positive for white blood cells and trace blood.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
None.
Principal Injury Giving Rise To The Claim
Patient developed bladder cancer.Loss of bladder.
Severity Of Injury
Permanent: Significant - Deafness, loss of limb, loss of eye, loss of one kidney or lung.

Legal Information

Date of Suit			Circuit Court Case Number
6/19/2006			CA06-447 55
County Suit Filed in			Date of Final Disposition
St. Johns			10/20/2009
Other Defendants Involved in this Claim

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
10/20/2009

Financial Information

Was there a settlement Resulting in payment to the Plaintiff?

Yes

Indemnity Paid by Insurer on behalf of Insured

$250,000

Loss Adjust Expense Paid to Defense Counsel

$21,826

All Other Loss Adjustment Expense Paid

$21,253

Injured Person's Total Non-Economic Loss

$250,000

Deductible

Injured Person's Total Economic Loss

Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely

Insurance company staff consulted with insured to discuss preventative measures. Risk management referral is made if appropriate.

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