Claims, errors, and compensation payments in medical malpractice litigation

David M. Studdert, Michelle M. Mello, Atul A. Gawande, Tejal K. Gandhi, Allen Kachalia, Catherine Yoon, Ann Louise Puopolo, Troyen A. Brennan

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2024-2033
Number of pages10
JournalNew England Journal of Medicine
Volume354
Issue number19
DOIs
StatePublished - May 11 2006
Externally publishedYes

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Malpractice
Jurisprudence
Compensation and Redress
Wounds and Injuries
Costs and Cost Analysis
Medical Errors
Legal Liability
Insurance Carriers
Lawyers
Health Expenditures
Physicians

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Studdert, D. M., Mello, M. M., Gawande, A. A., Gandhi, T. K., Kachalia, A., Yoon, C., ... Brennan, T. A. (2006). Claims, errors, and compensation payments in medical malpractice litigation. New England Journal of Medicine, 354(19), 2024-2033. https://doi.org/10.1056/NEJMsa054479

Claims, errors, and compensation payments in medical malpractice litigation. / Studdert, David M.; Mello, Michelle M.; Gawande, Atul A.; Gandhi, Tejal K.; Kachalia, Allen; Yoon, Catherine; Puopolo, Ann Louise; Brennan, Troyen A.

In: New England Journal of Medicine, Vol. 354, No. 19, 11.05.2006, p. 2024-2033.

Research output: Contribution to journalReview article

Studdert, DM, Mello, MM, Gawande, AA, Gandhi, TK, Kachalia, A, Yoon, C, Puopolo, AL & Brennan, TA 2006, 'Claims, errors, and compensation payments in medical malpractice litigation', New England Journal of Medicine, vol. 354, no. 19, pp. 2024-2033. https://doi.org/10.1056/NEJMsa054479
Studdert, David M. ; Mello, Michelle M. ; Gawande, Atul A. ; Gandhi, Tejal K. ; Kachalia, Allen ; Yoon, Catherine ; Puopolo, Ann Louise ; Brennan, Troyen A. / Claims, errors, and compensation payments in medical malpractice litigation. In: New England Journal of Medicine. 2006 ; Vol. 354, No. 19. pp. 2024-2033.
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abstract = "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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AU - Puopolo, Ann Louise

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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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