Healthcare: Recommended Reading: CG Publications: Fact Sheets: Selected Malpractice Claim Data

Selected Malpractice Claim Data

The unreliable nature of medical malpractice litigation is creating a crisis in our healthcare system. Studies show that results in malpractice litigation correlate with outcome, not negligence. Fear of litigation has fundamentally altered the practice of medicine, eroding the quality and availability of health care.

• A study published in the New England Journal of Medicine found "no association between the occurrence of an adverse event due to negligence or an adverse event of any type and payment. ... Among the malpractice claims we studied, the severity of the patient's disability, not the occurrence of an adverse event or an adverse event due to negligence, was predictive of payment to the plaintiff."
  • 10 of 24 cases involving no adverse event were settled for the plaintiffs (mean payment, $28,760);
  • 6 of 13 cases involving adverse events but no negligence were settled for the plaintiffs (mean payment $98,192);
  • 5 of 9 cases involving adverse events due to negligence were settled for the plaintiffs (mean payment $66,944);
  • 7 of 8 cases involving permanent disability were settled for the plaintiffs (mean payment $201,250).
    • Source: Troyen A. Brennan, M.D., J.D., M.P.H., Colin M. Sox, B.A., and Helen R. Burstin, M.D., M.P.H., "Relation between Negligent Adverse Events and the Outcomes of Medical Malpractice Litigation," The New England Journal of Medicine, Volume 335: 1963-1967, December 26, 1996, Number 26

• Of all malpractice claims closed in 2003:
  • 69.7% are dropped or dismissed.
  • 24.4% percent are settled.
  • 5.1% are lost at trial.
  • .8% are won at trial.
• While the experience varies somewhat from year-to-year, long-term data shows that the plaintiff receives remuneration in only 30% of all claims filed.
  • Source: Smarr, Lawrence E., Physicians Insurers Association of America, Testimony before Illinois General Assembly (based on data from PIAA Data Sharing Project), April 7, 2005

• In one study, the percentage of all adverse events attributed to "negligence" (as defined by physicians) was 27%. Only 2% of patients who suffered from an adverse event due to negligence filed a medical malpractice claim, and only 1 in 14 who experienced serious injury received compensation.
• Only 1 in 6 malpractice claims filed involved both negligence and injury. 40% of the cases with no evidence of negligence nevertheless resulted in payment to the patient. Fewer than 20% of malpractice claims actually filed had an identifiable basis in medical negligence.
  • Source: Harvard Medical Practice Study, 1990

• In a sampling of 11 states, medical malpractice filings rose 18% between 1993 and 2002. (The states in question are: Alabama, Arizona, Connecticut, Florida, Minnesota, Missouri, New York, North Dakota, Oregon, Puerto Rico, and Wyoming.)
• Colorado, Wyoming, and Mississippi saw increases in medical malpractice claims of 89, 73, and 54%, respectively, between 1998 and 2002.
  • Source: National Center for the Study of State Courts, Examining the Work of State Courts, 2003, p. 6 (Note: Florida does not distinguish medical malpractice filings from other types of professional malpractice.)

• At $425,000, the median award in medical malpractice trials was almost 16 times greater than the overall median award in all tort trials ($27,000).
  • Source: Bureau of Justice Statistics Bulletin, "Medical Malpractice Trials and Verdicts in Large Counties, 2001," April 2004, p. 1

• In 1996, 34% of all jury awards for medical liability exceeded $1 million. By 2000 this figure increased to 52%, and the average jury award was approximately $3.5 million.
  • Source: Alliance for Specialty Medicine, "ASM Before the House Judiciary Committee on the Subject of H.R. 5," March 2003, p. 2

• In 2002-03, 54% of medical malpractice verdicts were $1 million or more in the United States, compared to 40% between 1997-99.
  • Insurance Information Institute, "Tort Excess 2005: The Necessity for Reform from a Policy, Legal and Risk Management Perspective," p. 2

• One dollar in litigation costs corresponds to more than four dollars of unnecessary hospital costs related to defensive medicine.
  • Source: Kessler, Daniel P. and Mark McClellan. "How Liability Law Affects Medical Productivity." National Bureau of Economic Research, February 2000

• Plaintiff's case processing times (from filing to verdict or judgment) in the largest 75 counties averaged 33.2 months.
  • Source: Bureau of Justice Statistics Bulletin, "Civil Trial Cases and Verdicts in Large Counties, 2001," April 2004, p. 1  

• Only 22 cents of a dollar moving through the U.S. tort system compensates a plaintiff for economic loss (and 54% of that dollar never even reaches the victim):
  • 24 cents goes for non-economic loss;
  • 21 cents goes to administrative costs;
  • 19 cents goes to the plaintiff's attorney fees; and
  • 14 cents goes to defense costs.
    • Source: Tillinghast Towers Perrin, "U.S. Tort Costs, 2003 Update," December 2003, p. 17

• 2% to 8% of internists, obstetricians, and surgeons account for 75% to 85% of their specialties' awards and settlement costs.
  • Source: Hickson, Gerald B., et al., "Patient Complaints and Malpractice Risk." Journal of the American Medical Association, 2002: 2951

• The average claim payment in 1986 was $95,000, and in 2003 it was $328,757.
• The rate of claims has remained constant (although costs are rising). Approximately 15 claims are filed per 100 doctors--30% of which result in insurance payouts.
  • Source: Congressional Budget Office, "Limiting Tort Liability for Medical Malpractice," January 8, 2004; Physician Insurers Association of America, "PIAA: Protecting Healthcare," 2004

• Between 1996 and 1999, the average jury award in medical malpractice liability cases rose 76%. In the last 15 years, there has been a 600% rise in the number of mega-verdicts.
  • Source: Health Coalition on Liability and Access, "The Facts: The Crisis" (citing statistics from the US Department of Health and Human Services and the Physician Insurers Association of America)