Background We have previously shown that in New York State theinitiation of malpractice suits correlates poorly with the actualoccurrence of adverse events (injuries resulting from medicaltreatment) and negligence. There is little information on theoutcome of such lawsuits, however. To assess the ability ofmalpractice litigation to make accurate determinations, we studied51 malpractice suits to identify factors that predict paymentto plaintiffs.
Methods Among malpractice claims that we reviewed independentlyin an earlier study, we identified 51 litigated claims and followedthem over a 10-year period to determine whether the malpracticeinsurer had closed the case. We obtained detailed summariesof the cases from the insurers and reviewed the litigation filesif the outcome of a case differed from the outcome predictedin our original review.
Results Of the 51 malpractice cases, 46 had been closed as ofDecember 31, 1995. Among these cases, 10 of 24 that we originallyidentified as involving no adverse event were settled for theplaintiffs (mean payment, $28,760), as were 6 of 13 cases classifiedas involving adverse events but no negligence (mean payment,$98,192) and 5 of 9 cases in which adverse events due to negligencewere found in our assessment (mean payment, $66,944). Sevenof eight claims involving permanent disability were settledfor the plaintiffs (mean payment, $201,250). In a multivariateanalysis, disability (permanent vs. temporary or none) was theonly significant predictor of payment (P = 0.03). There wasno association between the occurrence of an adverse event dueto negligence (P = 0.32) or an adverse event of any type (P= 0.79) and payment.
Conclusions Among the malpractice claims we studied, the severityof the patient's disability, not the occurrence of an adverseevent or an adverse event due to negligence, was predictiveof payment to the plaintiff.
Source Information
From the Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115, where reprint requests should be addressed to Dr. Brennan.
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