Department File Number : | M202092208 |
Claim Number : | FP4314201 |
Date Submitted : | 4/13/2020 |
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 | Nicole | bursley | |||
Street Address | |||||
12724 GRAN BAY PKWY W, Suite 400 | |||||
City | State | Zip | |||
JACKSONVILLE | FL | 32258 | |||
Phone | Ext | Fax | E-Mail Address | ||
(517) 324 - 6562 | Nicole.Bursley@thedoctors.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Shannon | Price | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 39 Kent Rd., #1 | ||||
City | State | Zip Code | County | ||
Tifton | GA | 31793 | Out of state | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FP-CL099536 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME105923 | Surgery - Obstetrics - Gynecology |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
F | Leon | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
TALLAHASSEE MEMORIAL HOSPITAL | 100135 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Labor and Delivery Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
5/4/2012 | 5/15/2012 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Delivery of Pregnancy | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Delivery of Pregnancy resulting in shoulder dystocia | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Brachial Plexus Injury | |||||
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 | ||||
2/20/2014 | 14CA000040 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Leon | 4/2/2020 | ||||
Other Defendants Involved in this Claim | |||||
Tallahasee Memorial Hospital | |||||
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 | |||||
4/2/2020 |
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 | $57,653 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $18,227 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $1,500,000 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insurance company staff consulted with insured to discuss preventative measures. Patient Safety referral is made if appropriate. |
Updates | |
No updates found. |
Does Dr. SHANNON PRICE, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. SHANNON PRICE, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).