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    Claims, errors, and compensation payments in medical malpractice litigation

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    Author
    Studdert, DM; Mello, MM; Gawande, AA; Gandhi, TK; Kachalia, A; Yoon, C; Puopolo, AL; Brennan, TA
    Date
    2006-05-11
    Source Title
    NEW ENGLAND JOURNAL OF MEDICINE
    Publisher
    MASSACHUSETTS MEDICAL SOC
    University of Melbourne Author/s
    Studdert, David
    Affiliation
    Population Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    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. NEW ENGLAND JOURNAL OF MEDICINE, 354 (19), pp.2024-2033. https://doi.org/10.1056/NEJMsa054479.
    Access Status
    This item is currently not available from this repository
    URI
    http://hdl.handle.net/11343/26648
    DOI
    10.1056/NEJMsa054479
    Description

    C1 - Journal Articles Refereed

    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.
    Keywords
    Tort Law ; Law and Society; Epidemiology ; Understanding Legal Processes; Health Policy Evaluation

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