Claims that medicine is rife with malpractice lawsuits 'overblown'

According to new research, contrary to public perception, people who file lawsuits against doctors accusing them of medical mistakes rarely do so frivolously, and those who do submit trivial claims as a rule receive no payout.

Researchers at Harvard School of Public Health (HSPH) and Brigham and Women's Hospital found that the picture of a malpractice system that is rife with frivolous litigation is 'overblown'.

David Studdert who led the team of researchers at the Harvard School of Public Health, reviewed 1,452 closed claims from five malpractice insurance companies across the country. The focus was on four clinical categories: surgery, obstetrics, medication and missed or delayed diagnosis, areas that collectively account for about 80% of all malpractice claims filed in the U.S., covering 33,000 doctors, 61 hospitals and 428 outpatient facilities.

The study also found that very few patients who do make inappropriate claims receive pay outs from insurance companies.

The researchers say that although one third of the claims examined did not involve errors, most went unpaid, and one in six of those who are injured by medical errors receive no compensation at all.

Studdert's study supports previous research which has shown that the great majority of people injured by medical negligence never sue, and contradicts claims that the court system is awash with frivolous lawsuits.

Studdert says the system appears to cope well with rejecting claims without merit, but administrative costs are exorbitant and it is an expensive and time-consuming process.

Medical malpractice litigation is a hot political and health care issue in the U.S. and the Senate is expected to vote soon on legislation to impose a federal cap on non economic damages in malpractice suits, but Studdert believes more needs done than just putting caps on damages.

The researchers found that as a rule harmed patients waited five years for a payout with 54 cents of every dollar in their award going to lawyers, experts and courts.

It seems that four out of five plaintiffs lose the case if it goes to trial while three out of five patients receive money if they settle out of court.

Patients who do win in court usually received $799,365 in damages, which is almost twice as much as the $462,099 average out-of-court settlement.

George Annas a professor of health law at Boston University School of Public Health said few hospitals have chosen to take a patient's right to safety seriously and until they do, the threat of lawsuits will remain the only motivation for institutions to follow safer practices.

Studdert, an associate professor of law and public health at HSPH says their findings show that most malpractice claims involve medical error and serious injury, and that claims with merit are far more likely to be paid than claims without merit.

The study however paints a disparate picture of the current malpractice system.

The costs of litigating claims, including defense costs and contingency fees paid to plaintiffs' lawyers, averaged $52,521 per claim and overall, such administrative costs amounted to 54% of the compensation paid to plaintiffs.

Studdert says deciding negligence is a very expensive process and it takes an average of five years from injury to resolution of the claim.

Michelle Mello, an associate professor of health policy and law at HSPH and a co-author of the study says almost 80% of the administrative costs of the malpractice system are tied to resolving claims that have merit and finding ways to streamline the process should be central to reform efforts.

The findings appear in the May 11, 2006 issue of The New England Journal of Medicine.