State tort reform, outcomes determine malpractice awards

The amount of a malpractice award varies widely across states based on how badly the patient was injured and how strong the regional tort reform is, according to a study in this month's Journal of the American College of Surgeons.

"Such variability from state to state, in terms of awards and settlements, just says to me that the system is broken," study coauthor Mark A. Talamini, a professor and chair of surgery at the University of California, San Diego, Health System told American Medical News. "It's not working for patients who have been harmed, and it's not working for [doctors] for whom [having] a medical malpractice claim is a devastating personal and professional event."

Researchers looked at information from the National Practitioner Data Bank from 1990 to 2006, adjusting the average costs for inflation at 2006 rates. The average payment nationally was $262,727. They found that although the number of annual claims dropped by 154 per year, individual case payments increased by $3,200 a year.

Juries were more likely to award higher payments in Connecticut and Wisconsin.

"We live in a wealthy state, and I think when juries are presented with the cost-of-living increases and providing for housing and healthcare, it all goes into the equation" of awards, Steven Fleischman, an obstetrician-gynecologist and council chair of the Connecticut State Medical Society, told amednews. "The numbers are staggering." Connecticut, a state with one of the highest liability payments for surgeries in the country, has higher-than-average jury awards and settlements and few tort reform mechanisms such as a cap on damages.

Comparatively, Kansas, Michigan and Texas are the states least likely to have $1 million or higher payments. Kansas, for example, has a damages cap, upheld by the state Supreme Court.

Patient outcomes also affected damages, the study authors noted. Forty-two percent of claims cited improper performance, according to the study. Although most patients were inpatients and female with a mean age of 42 years, children were more likely to receive larger awards. Children younger than 10 years old were 70 percent more likely to receive a large payment, and patients older than 70 years were 80 percent less likely, study authors noted.

Both presidential candidates mentioned malpractice reform in their New England Journal of Medicine commentaries earlier this month, indicating opposition against defensive medicine and the cost of care.

For more information:
- read the amednews article
- check out the study abstract

Related Articles:
What states are best for physicians' careers, wallets?
Malpractice reform missing from national discussion
Aggressive care costs up to $800B
Cut malpractice costs with patient compensation
More docs suggest tort reform works