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Claims, errors, and compensation payments in medical malpractice litigation.
N Engl J Med. 2006 May 11; 354(19):2024-33.NEJM

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 dollars vs. 521,560 dollars, 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.

Authors+Show Affiliations

Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA. studdert@hsph.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16687715

Citation

Studdert, David M., et al. "Claims, Errors, and Compensation Payments in Medical Malpractice Litigation." The New England Journal of Medicine, vol. 354, no. 19, 2006, pp. 2024-33.
Studdert DM, Mello MM, Gawande AA, et al. Claims, errors, and compensation payments in medical malpractice litigation. N Engl J Med. 2006;354(19):2024-33.
Studdert, D. M., Mello, M. M., Gawande, A. A., Gandhi, T. K., Kachalia, A., Yoon, C., Puopolo, A. L., & Brennan, T. A. (2006). Claims, errors, and compensation payments in medical malpractice litigation. The New England Journal of Medicine, 354(19), 2024-33.
Studdert DM, et al. Claims, Errors, and Compensation Payments in Medical Malpractice Litigation. N Engl J Med. 2006 May 11;354(19):2024-33. PubMed PMID: 16687715.
* Article titles in AMA citation format should be in sentence-case
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, PY - 2006/5/12/pubmed PY - 2006/5/17/medline PY - 2006/5/12/entrez SP - 2024 EP - 33 JF - The New England journal of medicine JO - N Engl J Med VL - 354 IS - 19 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 dollars vs. 521,560 dollars, 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. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/16687715/Claims_errors_and_compensation_payments_in_medical_malpractice_litigation_ L2 - https://www.nejm.org/doi/10.1056/NEJMsa054479?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -