For example, the Centers for Disease Control and Prevention currently says that 75,000 patients die annually, in hospitals alone, from infections alone - just one cause of harm in just one kind of care setting.
[8] In 2013, BMJ Open performed a study in which they found that "failure to diagnose" accounted for the largest portion of medical malpractice claims brought against health professionals.
However, unlike other tort cases, many states require that a plaintiff take specific steps before a medical malpractice lawsuit can be filed, such as providing the defendant with advance notice of intent to sue, obtaining and filing with the court a certificate of merit from a qualified medical expert who attests to the validity of the plaintiff's cause of action, submitting the claim to a panel of legal and medical experts for evaluation, or participating in mediation in an attempt to resolve the claim without litigation.
At trial, both parties will usually present experts to testify as to the standard of care required, and other technical issues.
The trial court judge must consider evidence presented to determine whether an expert's "testimony rests on a reliable foundation and is relevant to the task at hand."
[16] A problem with Daubert is that the presiding judge may admit testimony which derives from highly contested data.
For every dollar spent on compensation, 54 cents went to administrative expenses (including lawyers, experts, and courts).
[22][23] A 2004 study of medical malpractice claims in the United States examining primary care malpractice found that though incidence of negligence in hospitals produced a greater proportion of severe outcomes, the total number of errors and deaths due to errors were greater for outpatient settings.
[25] Doctors' groups, patients, and insurance companies have criticized medical malpractice litigation as expensive, adversarial, unpredictable, and inefficient.
They claim that the cost of medical malpractice litigation in the United States has steadily increased at almost 12 percent annually since 1975.
[26] More recent research from the same source has found that tort costs as a percentage of GDP dropped between 2001 and 2009, and are now at their lowest level since 1984.
However, more recent research from the U.S. Department of Justice has found that median medical malpractice awards in states range from $109,000 to $195,000.
[28] These critics assert that these rate increases are causing doctors to go out of business or move to states with more favorable tort systems.
[30] A 2003 report from the General Accounting Office found multiple reasons for these rate increases, with medical malpractice lawsuits being the primary driver.
However, surveys show that the majority of the American public also vastly underestimate the extent of medical errors.
[34] At the same time, studies of these claims have found[35][36][37][38] that there is no problem of increasing malpractice verdicts and insurance costs driving doctors out of business.
The traditional approach to liability reform is to limit the amount of damages that can be recovered by a plaintiff (as noted above).
[1] Communication and Resolution Programs: When a medical error is identified, the patient is approached by the physician and/or health care system and they mutually arrive at a settlement.
Judge-directed compensation: A group of judges with expertise in medical malpractice meet with each sides attorneys and negotiates a settlement between the parties.
'"[40] Tort reform supporters argue that states have enacted such laws in order to keep health care costs low, in addition to helping curb medical malpractice litigation.
"[41] Texas law creates the most difficult "hurdles" in the United States for a plaintiff to succeed in recovering damages for any medical malpractice, even for such objective cases such as an emergency room exposure to the Ebola virus disease.
[45] Various studies have shown that the Texas tort-reform law has had no effect on healthcare costs or the number of physicians practicing in the state.
[44] A February 2014 study found "no evidence to support" the claim that "there had been a dramatic increase in physicians moving to Texas due to the improved liability climate.
"[48] A 1996 study by Daniel P. Kessler and Mark McClellan analyzing data on elderly Medicare beneficiaries treated for two serious cardiac diseases in 1984, 1987, and 1990 determined that "malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications.
"[49] A a 2004 Congressional Budget Office (CBO) report using data from a private actuarial firm and the Centers for Medicare and Medicaid Services (CMS) found that malpractice costs (excluding "defensive medicine") account for less than 2 percent of health care spending.
[50] A 2006 PriceWaterhouseCoopers report for America's Health Insurance Plans (a health-insurer trade association) used the 2 percent figure and an extrapolation from the Kessler and McClellan report to estimate that the combined cost of insurance and defensive medicine accounts for 10 percent of total health care costs in the U.S.[51] In 2009, the CBO "concluded that implementing a package of five malpractice reforms would reduce national health spending by about 0.5 percent.
The researchers, led by Daniel A. Waxman, examined 3.8 million Medicare patient records from hospital emergency departments from 1997 to 2011, comparing care in three states that enacted strict malpractice reform laws about a decade earlier (Georgia, Texas and South Carolina) to care in neighboring states that did not enact such laws.
The study found that the laws had no effect on whether doctors ordered resource-intensive care (e.g., CT or MRI scans and hospitalization).