May 10, 2006 -- A proposed bill designed to limit the amount of money juries award in medical malpractice cases is a hot topic in Congress. Many lawmakers say the limits would help reduce frivolous lawsuits.
Critics claim such suits have both clogged the courts and crippled the health care system. But a new, government-funded study shows little evidence to back this up.
The Harvard School of Public Health study involved rigorous reviews of 1,452 randomly selected malpractice claims. Researchers concluded that frivolous litigation is far from rampant and does not cost the system as much as some claim.
The researchers concluded that the lawsuits were decided correctly about three-fourths of the time, researcher David M. Studdert, MPH, ScD, tells WebMD. In one in four cases, however, they found that the judge or jury got it wrong.
The study is published in the May 11 issue of The New England Journal of Medicine. It was supported by a grant from the U.S. Health and Human Services Agency for Healthcare Research and Quality.
"You can certainly make the case that getting it wrong about a quarter of the time is problematic," Studdert says. "But this is a fairly positive outcome when you consider some of the claims that have been made about how bad the system is."
The 'Big Four'
The malpractice cases that were reviewed involved claims of medication, obstetric, surgical, and diagnostic errors.
"These are the big four," Studdert says. "Most insurers will tell you that they represent about 80% to 90% of the [medical malpractice] cases they see."
Researchers reviewed the claims and all medical records pertaining to them.
Nine out of 10 claims involved a physical injury, which was generally severe, with 80% resulting in a major disability and 26% resulting in death.
The experts found that 63% of these claims were due to medical errors. The remaining 37% didn't involve errors, although some were considered to be close calls.
Among the other major findings from the study:
- In 73% of cases in which no medical errors were found by the researchers, plaintiffs did not receive compensation.
- When meritless claims were paid, the payments tended to be smaller than claims that were judged to have merit ($313,205 vs. $521,560).
- In three out of four cases where claims of medical malpractice were deemed justified, plaintiffs won the cases and were compensated.
- In the 27% of cases where the researchers concluded that the judges or jury got it wrong, 16% involved legitimate claims of medical injury that were not compensated and just 10% involved compensated claims that did not appear to be caused by medical error.
- Meritless or frivolous claims accounted for 13% to 16% of the direct cost of medical malpractice.
The average medical malpractice case takes roughly five years to resolve and costs around $50,000. And it is estimated that for every dollar awarded to plaintiffs in medical malpractice lawsuits, 54 cents goes to paying the lawyers, experts, and other administrative costs of bringing the litigation.
"Many current tort reform initiatives, such as caps on noneconomic damages, are motivated by a perception that 'jackpot' awards in frivolous suits are draining the system," says researcher Michelle Mellow, PhD. "But nearly 80% of the administrative costs of the malpractice system are tied to resolving claims that have merit."
Studdert and Mello say lawmakers should focus their efforts on streamlining the process of resolving medical disputes. Mediation, arbitration, and even special courts that only deal with medical issues could help, they say.
The U.S. Congress has been considering a bill to limit the amount plaintiffs can ask seek for noneconomic damages, also known as pain and suffering, in medical malpractice lawsuits. On Monday, Senators agreed to table a vote on the legislation until at least next year.
The American Medical Association supports the bill. An AMA spokesman says far from showing that such reforms aren't needed, the Harvard study offers more evidence that they are.
AMA board member Cecil Wilson, MD, says the finding that almost 40% of the lawsuits reviewed lacked evidence of error shows there is a problem.
"The costs of these meritless lawsuits are borne by patients who have decreased access to care as physicians are forced to spend significant time and money defending against them," Wilson says.