| Department File Number : | M201783826 |
| Claim Number : | 217886 |
| Date Submitted : | 4/4/2018 |
| Insurer Information | |||||
| Insurer Name | Coverage Type | ||||
| PROASSURANCE INDEMNITY COMPANY, INC. | Primary | ||||
| Insurer FEIN | Professional License Number | ||||
| 63-0720042 | |||||
| Insurer Contact Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Denise | Stokes | |||
| Street Address | |||||
| 100 Brookwood Place | |||||
| City | State | Zip | |||
| Birmingham | AL | 35209 | |||
| Phone | Ext | Fax | E-Mail Address | ||
| (205) 802 - 4790 | (205) 802 - 4710 | claimscompliancereporting@proassurance.com | |||
| Insured Information | |||||
| Type | First Name | MI | Last Name | ||
| Individual | Pamela | Schwartz | |||
| Insurer Type | Street Address of Practice | ||||
| Licensed | 825 Whiper Woods Drive | ||||
| City | State | Zip Code | County | ||
| Lakeland | FL | 33813 | Polk | ||
| Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
| MP103721 | $250,000 | $750,000 | |||
| Profession or Business | Other Profession or Business | ||||
| Osteopathic Physician | |||||
| License Number | Specialty Code & Classification | Certification Number | |||
| OS8613 | Gynecology - Minor Surgery | ||||
| Injured Person Information | |||||
| First Name | MI | Last Name | Date of Birth | ||
| Street Address | Gender | County where Injury Occurred | |||
| F | Pinellas | ||||
| City | State | Zip Code | |||
| Location where injury occured | Other location where injury occured | ||||
| Hospital Inpatient Facility | |||||
| Name of Institution | Code | ||||
| MEASE HOSITAL - COUNTRYSIDE | 110001 | ||||
| Location of Institutional Injury | Other Location of Institutional Injury | ||||
| Labor and Delivery Room | |||||
| Date of Occurrence | Date Reported to Insurer | ||||
| 9/4/2015 | 1/30/2017 | ||||
| Diagnostic Information | |||||
| Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
| Pain with pregnancy | |||||
| Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
| No operation, diagnostic, or treatment procedure | |||||
| Diagnostic Code : | |||||
| Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
| No misdiagnosis | |||||
| Principal Injury Giving Rise To The Claim | |||||
| Uterin rupture with fetal demise | |||||
| Severity Of Injury | |||||
| Permanent: Death. | |||||
| Legal Information | |||||
| Date of Suit | Circuit Court Case Number | ||||
| *NR | |||||
| County Suit Filed in | Date of Final Disposition | ||||
| *NR | 1/30/2017 | ||||
| Other Defendants Involved in this Claim | |||||
| Anchesta, Arleigh Mease Countyside Hospital Ladies and Babies OB-GYN Associates LLC Baycare Health System Inc d/b/a Mease Countyside Trustees of Mease Countryside Hospital Sites, Ira | |||||
| Stage of Legal System at which Settlement was Reached or Award Made | |||||
| Within the pre-suit period as set forth in 766.106 (more than 90 days before suit is filed). | |||||
| Final Method of Claim Disposition | |||||
| Settled by parties | |||||
| Court Decision | Other | ||||
| No Court Proceedings. | |||||
| Arbitration | |||||
| Claim not subject to Arbitration. | |||||
| Date of Payment | |||||
| 11/16/2017 | |||||
| Financial Information | |||||||||||||||||||||
| Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
| Indemnity Paid by Insurer on behalf of Insured | $150,000 | ||||||||||||||||||||
| Loss Adjust Expense Paid to Defense Counsel | $29,819 | ||||||||||||||||||||
| All Other Loss Adjustment Expense Paid | $6,635 | ||||||||||||||||||||
| Injured Person's Total Non-Economic Loss | $150,000 | ||||||||||||||||||||
| Deductible | $0 | ||||||||||||||||||||
| Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
| Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
| Insured discussed case with defense counsel, insurance personnel, and medical experts. | |||||||||||||||||||||
| Updates | ||||||||||
| Date of Change: | 12/13/2017 9:43:32 AM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
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| Date of Change: | 1/5/2018 4:39:36 PM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
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| Date of Change: | 3/29/2018 12:17:55 PM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
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| Date of Change: | 4/4/2018 3:28:28 PM | |||||||||
| Reason for Change: | Updated ALAE information | |||||||||
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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.
Does Dr. PAMELA SCHWARTZ, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. PAMELA SCHWARTZ, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).