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Written By:  Steven Fox

From:  Medscape Medical News

May 14, 2012 — Results of a new study of medical malpractice claims offer a mix of reassurance and sobering reality.

According to the results, 55.2% of medical malpractice claims that required some defense cost led to litigation. However, of the claims that do go to court, most are ultimately decided in the physician's favor.

For physicians, that is the good news.

The sobering news is that litigated claims often take months or years to be resolved, according to the study, which was published online May 14 in the Archives of Internal Medicine.

"Malpractice claims that undergo litigation are an important source of concern to physicians, yet national data are lacking on the frequency of litigation, how litigation is typically resolved, and how long litigation takes to be resolved," write Anapam Jena, MD, PhD, from the Department of Medicine, Massachusetts General Hospital, and the Harvard Medical School, Boston, and colleagues.

The researchers sifted through data from all 50 US states for the years 2002 through 2005 and analyzed the 10,056 malpractice claims that necessitated some defense costs. They calculated how many claims resulted in litigation and checked to see how those claims were resolved by specialty. They also analyzed how long it took to resolve various types of claims.

Frequency of litigated claims ranged from 46.7% for anesthesiologists to 62.6% for obstetricians and gynecologists. About 53% of claims against internists and medicine-based subspecialists triggered litigation, the authors say.

As to outcomes of litigation, 54.1% of the cases across all specialties were dismissed by the court. Rates of dismissal were highest for cases brought against internists and medicine-based subspecialists (61.5%) and lowest for cases against pathologists (36.5%).

In cases involving internists and pathologists, just more than a third of litigated claims ended up being resolved before a verdict was reached by the court, the authors say. In contrast, the proportion of claims settled before a verdict was 49.6% for pathologists.

Across all specialties, only 4.5% of claims were ultimately decided by a trial verdict. By specialty, that ranged from a high of 7.4% for pathologists to a low of 2.0% for anesthesiologists. Only 2.7% of cases brought against internists and medicine-based subspecialists went to a verdict.

When cases did progress to a final verdict, 79.6% were decided in favor of the defendant.

Dealing with malpractice claims is often a lengthy process, according to the study results. The mean time required to resolve claims was 19.0 months, which included 11.6 months for nonlitigated claims and 25.1 months for claims that were litigated.

For claims that were resolved in a trial, the mean duration was 39.0 months for cases decided in favor of the defendants and 43.5 months for cases decided in favor of the plaintiffs.

The authors conclude, "The substantial portion of litigated claims that are not dismissed in court and the length of time required to resolve litigated claims more generally may help explain why malpractice claims undergoing litigation are an important source of concern to physicians."

The authors have disclosed no potential conflicts of interest.

Arch Intern Med. Published online May 14, 2012.