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Reform efforts have spurred dramatic drops in malpractice lawsuits in Pennsylvania, Texas


Likely coming to a state near you: Medical malpractice reform. Why have malpractice case filings dropped more than 45%?nearly 70% in Philadelphia?since two significant rule changes implemented by the Pennsylvania Supreme Court? And what has been the effect of a Texas proposition that put a cap on noneconomic damages in medical malpractice claims?

Two significant rule changes implemented by the Pennsylvania Supreme Court have had a dramatic effect on the number of medical malpractice lawsuit filings, according to a recent report from the Administrative Office of Pennsylvania Courts (AOPC).

Since the “baseline” years of 2000-2002, statewide malpractice claims have declined 45.4%. In Philadelphia, Pennsylvania, the state’s judicial district with the largest caseload, the drop over 10 years has hit 70%.

What’s behind the big decline? Two rule changes are making all the difference. First, attorneys now are required to obtain from a medical professional a certificate of merit that establishes that the medical procedures in a case fall outside acceptable standards. The second rule change put a damper on “venue shopping,” requiring medical malpractice actions to be brought only in the county where the cause of action takes place and not where attorneys think juries might be more sympathetic. The baseline years used in the AOPC report are the period just prior to the two rules changes.

So, has the drop in filings led to a drop in malpractice insurance premiums for physicians? Unfortunately, insurance companies in Pennsylvania have not lowered liability premiums, according to the Pennsylvania Medical Society. Also, the state’s legislators have refused to limit the size of noneconomic medical malpractice awards, which tort reform fans favor to help lower the cost of insurance. Thus, while the decline in malpractice lawsuit filings is good news for Pennsylvania physicians, the bad news lingers.

Meanwhile, in Texas, as part of comprehensive tort reform in 2003, Proposition 12 placed a $750,000 cap on noneconomic damages in medical malpractice lawsuits and limited an individual physician’s liability to $250,000.

That, concludes a study recently reported in the Journal of the American College of Surgeons, is behind a nearly 80% decrease in the prevalence of surgical malpractice lawsuits at one academic medical center.

Researchers at the University of Texas Health Science Center at San Antonio conducted the study using data extracted from two hospital databases. They reviewed malpractice suit prevalence and associated costs across an 18-year period, from 1992 to 2010, and found that the prevalence of lawsuits decreased substantially following tort reform. During the pre-reform period, prevalence measured at 40 suits per 100,000 surgeries. After tort reform, it dropped to eight suits per 100,000 surgeries, showing a relative reduction of almost 80%.

The study also showed that tort reform brought about reductions in legal costs and malpractice insurance premiums for individual surgeons. In 2002, malpractice insurance premiums were $10,000 per surgeon. By 2010, the premium had dropped to $2,700.

Ronald M. Stewart, MD, FACS, the study’s lead author, touted the benefits of tort reform for surgeons and other healthcare providers. He also pointed to benefits for patients, noting that fewer lawsuits and lower associated costs lead to reduced healthcare costs overall and improved quality of care.

Go back to the current issue of eConsult.

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