Relation between negligent adverse events and the outcomes of medical-malpractice litigation.
BACKGROUND
We have previously shown that in New York State the initiation of malpractice suits correlates poorly with the actual occurrence of adverse events (injuries resulting from medical treatment) and negligence. There is little information on the outcome of such lawsuits, however. To assess the ability of malpractice litigation to make accurate determinations, we studied 51 malpractice suits to identify factors that predict payment to plaintiffs.


METHODS
Among malpractice claims that we reviewed independently in an earlier study, we identified 51 litigated claims and followed them over a 10-year period to determine whether the malpractice insurer had closed the case. We obtained detailed summaries of the cases from the insurers and reviewed the litigation files if the outcome of a case differed from the outcome predicted in our original review.


RESULTS
Of the 51 malpractice cases, 46 had been closed as of December 31, 1995. Among these cases, 10 of 24 that we originally identified as involving no adverse event were settled for the plaintiffs (mean payment, $28,760), as were 6 of 13 cases classified as involving adverse events but no negligence (mean payment, $98,192) and 5 of 9 cases in which adverse events due to negligence were found in our assessment (mean payment, $66,944). Seven of eight claims involving permanent disability were settled for the plaintiffs (mean payment, $201,250). In a multivariate analysis, disability (permanent vs. temporary or none) was the only significant predictor of payment (P=0.03). There was no association between the occurrence of an adverse event due to negligence (P = 0.32) or an adverse event of any type (P=0.79) and payment.


CONCLUSIONS
Among the malpractice claims we studied, the severity of the patient's disability, not the occurrence of an adverse event or an adverse event due to negligence, was predictive of payment to the plaintiff.
Brennan
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TA
Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA.
Sox
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CM
Burstin
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HR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D007348:Insurance, Health; D016365:Liability, Legal; D016015:Logistic Models; D008297:Male; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D019300:Medical Errors / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D009518:New York