TY - JOUR
T1 - Claims, errors, and compensation payments in medical malpractice litigation
AU - Studdert, David M.
AU - Mello, Michelle M.
AU - Gawande, Atul A.
AU - Gandhi, Tejal K.
AU - Kachalia, Allen
AU - Yoon, Catherine
AU - Puopolo, Ann Louise
AU - Brennan, Troyen A.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2006/5/11
Y1 - 2006/5/11
N2 - BACKGROUND: In the current debate over tort reform, critics of the medical malpractice system charge that frivolous litigation - claims that lack evidence of injury, substandard care, or both - is common and costly. METHODS: Trained physicians reviewed a random sample of 1452 closed malpractice claims from five liability insurers to determine whether a medical injury had occurred and, if so, whether it was due to medical error. We analyzed the prevalence, characteristics, litigation outcomes, and costs of claims that lacked evidence of error. RESULTS: For 3 percent of the claims, there were no verifiable medical injuries, and 37 percent did not involve errors. Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy - nonpayment of claims associated with errors. When claims not involving errors were compensated, payments were significantly lower on average than were payments for claims involving errors ($313,205 vs. $521,560, P = 0.004). Overall, claims not involving errors accounted for 13 to 16 percent of the system's total monetary costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including those involving lawyers, experts, and courts). Claims involving errors accounted for 78 percent of total administrative costs. CONCLUSIONS: Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant.
AB - BACKGROUND: In the current debate over tort reform, critics of the medical malpractice system charge that frivolous litigation - claims that lack evidence of injury, substandard care, or both - is common and costly. METHODS: Trained physicians reviewed a random sample of 1452 closed malpractice claims from five liability insurers to determine whether a medical injury had occurred and, if so, whether it was due to medical error. We analyzed the prevalence, characteristics, litigation outcomes, and costs of claims that lacked evidence of error. RESULTS: For 3 percent of the claims, there were no verifiable medical injuries, and 37 percent did not involve errors. Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy - nonpayment of claims associated with errors. When claims not involving errors were compensated, payments were significantly lower on average than were payments for claims involving errors ($313,205 vs. $521,560, P = 0.004). Overall, claims not involving errors accounted for 13 to 16 percent of the system's total monetary costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including those involving lawyers, experts, and courts). Claims involving errors accounted for 78 percent of total administrative costs. CONCLUSIONS: Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant.
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U2 - 10.1056/NEJMsa054479
DO - 10.1056/NEJMsa054479
M3 - Review article
C2 - 16687715
AN - SCOPUS:33646483918
SN - 0028-4793
VL - 354
SP - 2024
EP - 2033
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 19
ER -