December 11th, 2006

The Myth of Frivolous Litigation

Some accept as gospel that frivolous lawsuits are a big part of medical malpractice litigation: Baseless claims brought by uninjured people, or whose injuries were not caused by negligence. Not so, according to “Claims, Errors, and Compensation Payments in Medical Malpractice Litigation,” a study by the Harvard School of Public Health and the Harvard Risk Management Foundation that was published earlier this year in the New England Journal of Medicine.

The results, in fact, are the opposite of what the tort “deformers” claim, based on results from 1,452 randomly selected, closed medical malpractice files. The reviewers found that 97 percent had indeed suffered harm. In about one-third of these patients, the damage wasn’t clearly attributable to negligent medical treatment, a wrong prescription, or a misdiagnosis. Most of those claims were correctly denied compensation, the team reports.

According to the study, 73 percent of plaintiffs whose claims had merit received compensation.

The study also found that just six people had received compensation that were uninjured and 145 had injuries that had not been convincingly linked to medical error. On the other hand, 236 plaintiffs who did suffer an injury from medical error received no compensation. The authors wrote:

One in six claims involved errors and received no payment. The plaintiffs behind such unrequited claims must shoulder the substantial economic and noneconomic burdens that flow from preventable injury. Moreover, failure to pay claims involving error adds to a larger phenomenon of underpayment generated by the vast number of negligent injuries that never surface as claims.

Eighty percent of the claims involved injuries deemed to have caused significant or major disability or death. In only 3% of the claims, no adverse outcomes from medical care were evident.

Since the majority of payments from insurance companies went to people who had been harmed by medical errors and not to people with baseless claims, the authors said that the “moves to combat frivolous litigation will have a limited effect on total costs.”

Taking direct aim at politicians and business lobbyists, the authors wrote that:

“The profile of non-error claims we observed does not square with the notion of opportunistic trial lawyers pursuing questionable lawsuits in circumstances in which their chances of winning are reasonable and prospective returns in the event of a win are high. Rather, our findings underscore how difficult it may be for plaintiffs and their attorneys to discern what has happened before the initiation of a claim and the acquisition of knowledge that comes from the investigations, consultation with experts, and sharing of information that litigation triggers. Previous research has described tort litigation as a process in which information is cumulatively acquired.”

It is not the first time that a Harvard study has debunked the popular myths spread by insurance companies or politicians with respect to medical malpractice. It had happened back in 1991 by the Harvard Medical Practice Study that found that only eight percent of those injured by medical negligence brought lawsuits. But that is a post for another day.

[Addendum, 1/29/07 — This blog was cross-posted to TortDeform on January 25, 2007, resulting in much spirited commentary]

Links to this post:

why new york medical malpractice insurance jumped 14%
you may have seen the screaming new york headlines: doctors hit with 14% increase in medical malpractice rates! doctors in high risk specialties paying 6-figure insurance premiums! insurance reserves so low carriers may become insolvent

posted by Eric Turkewitz @ July 31, 2007 9:05 AM

why new york medical malpractice insurance jumped 14%
you may have seen the screaming new york headlines: doctors hit with 14% increase in medical malpractice rates! doctors in high risk specialties paying 6-figure insurance premiums! insurance reserves so low carriers may become insolvent

posted by Eric Turkewitz @ July 31, 2007 8:52 AM

health court legislation again introduced to congress
cross-posted from new york personal injury law blog. legislation that would provide federal funding for experimental “health courts” for medical malpractice cases has once again been introduced in both houses of congress.

posted by Eric Turkewitz @ May 30, 2007 9:55 AM

the myth of frivolous litigation
cross-posted from ny personal injury law blog. some accept as gospel that frivolous lawsuits are a big part of medical malpractice litigation: baseless claims brought by uninjured people, or whose injuries were not caused by negligence.

posted by Eric Turkewitz @ January 25, 2007 2:26 PM

 

December 10th, 2006

Lawyers Push For Greater Workplace and Product Safety

Business oriented Bloomberg News did a piece this week on the changing landscape for tort “reform” given the election results. A few snippets from the article:

Trial lawyers, who say they were demonized during 12 years of Republican congressional rule, are seeking vindication with the Democrats’ return to power…Their plans include pushing tougher enforcement of workplace-safety rules and enhanced patients’ rights.

They say the shift in power also signals an end to the so- called tort reform backed by President George W. Bush, which was aimed at limiting awards in personal-injury lawsuits against doctors and U.S. corporations.

“The Republicans had a hell of a chance for the last couple of years and really didn’t get that far,” said John Coale, a trial attorney at the Coale Cooley firm in Washington. “And now it’s over.”

Businesses are girding for a fight in Congress over workplace safety and such other issues as making it a federal crime for chief executive officers and other company officials to knowingly introduce defective products that kill or severely injure consumers.
….
Bush’s major victory in limiting lawsuits was 2005 legislation requiring the biggest class-action suits to be filed in federal court rather than state courts, which have been more sympathetic to plaintiffs.

The Republican-controlled Congress failed to pass proposals to place caps on medical-malpractice awards and to create a $140 billion fund for asbestos-exposure victims.


Linda Lipsen, chief lobbyist for the [The Association of Trial Lawyers of America] would like to see Congress strip the insurance industry of its exemption from antitrust laws, a move that would pave the way for suits against insurers. She also suggested there might be congressional hearings one day on “why there are 98,000 deaths per year” in the medical industry.

Trial attorneys will “alert the Congress to areas where they can encourage safety,” including “cars, airplanes, the environment, clean air and water, medical procedures, hospitals,” Lipsen said. “Our job is to make sure these industries are accountable.”

 

December 7th, 2006

Tort "Reform", Trent Lott, and Changing Fortunes

I learned at Tortdeform.com that Senator Trent Lott, a long time proponent of reducing the rights of consumers, may be having a change of heart.

The reason? Seems his home got wiped out by Katrina and State Farm won’t pay him what he thinks he is owed after they took his premiums. The shoe, it appears, is suddenly on the other foot for Senator Lott, as he now must do battle with his insurance company. He was victimized once by the storm, and doesn’t want to see it happen again.

He therefore hired high-profile plaintiff’s attorney Richard Scruggs.

The turnabout in personal fortune reminds me of Frank Cornelius, who wrote an op-ed piece for the New York Times back in 1994. Mr. Cornelius tells his story in this excerpt better than I could:

Crushed By My Own Reform By Frank Cornelius
In 1975, I helped persuade the Indiana Legislature to pass what was acclaimed as a pioneering reform of the medical malpractice laws: a $500,000 cap on damage awards, and elimination of all damages for pain and suffering. I argued successfully that such limits would reduce health care costs and encourage physicians to stay in Indiana — the same sort of arguments that now underpin the medical industry’s call for national malpractice reform.

Today, from my wheelchair, I rue that that accomplishment. Here is my story.

On February 22, 1989, I underwent routine arthroscopic surgery after injuring my left knee in a fall. The day I left the hospital, I experienced a great deal of pain and called the surgeon several times. He called back the next day and told my wife to get me a bedpan. He then left on a skiing trip. I sought out another surgeon, who immediately diagnosed my condition as a reflex sympathetic dystrophy — a degenerative nervous disorder brought on by trauma or infection, often during surgery. * * *

At the age of 49, I am told that I have less than two years to live.

My medical expenses and lost wages, projected to retirement if I should live that long, come to more than $5 million. Claims against the hospital and physical therapist have been settled for a total of $500,000 — the limit on damages for a single incident of malpractice. The Legislature has raised that cap to $750,000, and I may be able to collect some extra damages if I can sue those responsible for the August 1990 incident that nearly killed me. But apparently because of bureaucratic inertia, the state medical panel that certifies such claims has yet to act on mine.

The kicker, of course, is that I fought to enact the very law that limits my compensation. All my suffering might have been worthwhile, on some cosmic scale, if the law had accomplished its stated purpose. But it hasn’t.

Indiana’s health care costs increased 139.4 percent from 1980 to 1990 — just about the national average. The state ranked 32nd in per capita health spending in 1990 — the same as in 1980.

It is understandable that the damage cap has done nothing to curb health care spending; the two have almost nothing to do with each other. In 1992, the Congressional Budget Office reported that medical malpractice litigation accounted for less than 1 percent of total healthcare spending. I doubt that the percentage in Indiana is much different.

Make no mistake; damage caps are arbitrary, wholly disregarding the nature of the injury and the pain experience by the plaintiff. They make it harder to seek and recover compensation for medical injuries; extend unwarranted special protection to the medical industry; and remove the only effective deterrent to negligent medical care, since the medical profession has never done an effective job of disciplining negligent doctors.

Medical negligence cannot be reduced simply by restricting consumers’ legal rights. That will happen only when the medical industry begins to effectively police its own. I don’t expect to see that day.

 

November 18th, 2006

Will the election results curb tort "reform"?

I put “reform” in quotes for a reason. Because those that tout such reform are really interested in granting various forms of protection and immunities to those who have caused injury to others. Reform generally means an improvement, but those with a political agenda to reduce the rights of the injured have reversed the meaning.

The election of Democratic majorities in both the House and Senate seems certain to have an effect on those who had championed corporate protections against law suits. As the National Law Journal notes in this November 16, 2006 piece:

So-called tort reform is just one of a number of legal agenda issues likely to be placed on the back burner or to undergo redefinition when the new Congress begins in January.

The House Judiciary Committee under Republican control has been a reliable source of tort system-related legislation, including medical malpractice liability limits, new sanctions on attorneys who file frivolous lawsuits, proposed constitutional amendments on a variety of contentious social issues, and efforts to limit what some of its members believe are unaccountable and activist federal judges. A good number of those proposals have been adopted by the Republican House only to be blocked in the narrowly divided, yet Republican-controlled Senate.

That part of the Republican agenda that carries this banner of reform has always smacked of hypocrisy to me. The party, after all, repeatedly claims to champion personal responsibility for one’s acts. Yet in this arena they have done the exact opposite — asking that protections be granted to corporations or physicians so that they would not be held responsible for their negligent or reckless acts. I can only think of one reason for this hypocritical position. In the arena of our tort system, it seems that campaign contributions carry more weight than political philosophy.

On my web site, I put together a page of materials regarding changes to our civil justice system that have been advocated by some. It is a subject I expect to return to in the future.