Department File Number : | M201885241 |
Claim Number : | 53787 |
Date Submitted : | 7/19/2018 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (404) 842 - 3319 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Marcelo | C | Branco | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8333 N. David Hwy. | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 32516 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1600507 13 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME56014 | Cardiovascular Disease - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WEST FLORIDA REG. MED. CTR (PENSACOLA) | 100231 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
6/2/2014 | 6/30/2015 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Coronary artery atherosclerosis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Cardiac catheterization | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged improper performance of cardiac catheterization with excessive Propofol | |||||
Principal Injury Giving Rise To The Claim | |||||
V-fib | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/6/2015 | 2015CA001615 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Escambia | 6/25/2018 | ||||
Other Defendants Involved in this Claim | |||||
West Florida Regional Medical Center NW Fl Heart Group | |||||
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 | |||||
4/10/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $560,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $49,383 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $36,429 | ||||||||||||||||||||
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 | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |||||||
Date of Change: | 7/19/2018 10:35:22 AM | ||||||
Reason for Change: | Report updated to reflect Court Document final disposition date of 6/25/18 | ||||||
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Department File Number : | M201678431 |
Claim Number : | 45469 |
Date Submitted : | 5/16/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MAG MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
58-1449198 | |||||
Insurer Contact Information | |||||
Type | Entity Name | ||||
Entity | MAG MUTUAL INSURANCE COMPANY | ||||
Street Address | |||||
8427 South Park Circle Suite 130 | |||||
City | State | Zip | |||
Orlando | FL | 32819 | |||
Phone | Ext | Fax | E-Mail Address | ||
(407) 370 - 3813 | (407) 370 - 2247 | ctschanz@magmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Marcelo | C | Branco | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 8333 N. Davis Hwy. | ||||
City | State | Zip Code | County | ||
Pensacola | FL | 32516 | Escambia | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
PSL 1600507 11 | $1,000,000 | $3,000,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME56014 | Cardiovascular Disease - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Escambia | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
WEST FLORIDA REG. MED. CTR (PENSACOLA) | 100231 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Operating Suite | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/25/2012 | 7/17/2013 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Severe aortic stenosis | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Placement of pacemaker | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
Alleged improper placement of pacemaker leads | |||||
Principal Injury Giving Rise To The Claim | |||||
Bowel perforation | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/18/2013 | 213-CA-002286 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Escambia | 4/28/2016 | ||||
Other Defendants Involved in this Claim | |||||
NW Florida Heart Group | |||||
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 | |||||
4/28/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $285,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $28,623 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $7,313 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Risk management has counseled insured |
Updates | |
No updates found. |
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Does Dr. MARCELO C BRANCO, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. MARCELO C BRANCO, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).