Stability, Not Crisis: Medical Malpractice Claim Outcomes in Texas, 1988–2002

Abstract

Using a comprehensive database of closed claims maintained by the Texas Department of Insurance since 1988, this study provides evidence on a range of issues involving medical malpractice litigation, including claim frequency, payout frequency, payment amounts, defense costs, and jury verdicts. The data present a picture of remarkable stability in most respects and slow, predictable change in others. We find no evidence of the medical malpractice crisis that produced headlines over the last several years and led to legal reform in Texas and other states. The rapid changes in insurance premiums that sparked the crisis appear to reflect insurance market dynamics, largely disconnected from claim outcomes.Controlling for population growth, the number of large paid claims (over $25,000 in real 1988 dollars) was roughly constant from 1991-2002. Controlling for the quantity of health care delivered (based either on real health care spending or number of physicians), the frequency of large paid claims declined over this period. The number of small paid claims declined sharply. Payout per claim on large claims was constant over 1988-2002, while jury awards were constant or even declined. Real defense costs rose at 4.4% per year, and produced an average 1% annual increase in the real total cost to insurers per large paid claim. Jury verdicts showed no significant trend.

Real Juries

“…A recent study of malpractice claims, based on evidence from the Texas Department of Insurance, directly contradicts contentions that the sharp increases in insurance rates for medical malpractice in the past decade are the result of jury behavior or a tort crisis (Black et al 2005). The study revealed no increase in the number of claims, no increase in the median or mean pay outs, and no change in the percentage of claims with payments of more than $1 million.…”

How reason for surgery and patient weight affect verdicts and perceptions in medical malpractice trials: A comparison of students and jurors

“…There is a widespread perception, especially in the medical community, that malpractice litigation is out of control (Bornstein & Robicheaux, 2008). Although this perception has little basis in fact (e.g., Black, Silver, Hyman, & Sage, 2005), it has been a major impetus for the tort reform movement (Bornstein & Robicheaux, 2008; Halton & McCann, 2004). Moreover, advocates of tort reform place much of the blame for the perceived ills of the civil justice system squarely on the jury (Landsman, 2008).…”

Malpractice Risk Among US Pediatricians

“…We also observed that mean time to resolution for pediatrics cases increased significantly over our sample period, consistent with past findings. 4,22 Lengthy time to resolution is an additional cost of medical malpractice that is often not estimated but may be substantial when there is lost practice time and nonmonetary costs to physicians, such as reputational damage and anxiety. 3 Pediatric patients and their families are also adversely affected by delays in compensation and personal closure that are caused by lengthy time to resolution.…”