CASE REVIEW

Case Review: Patient Falls



Case Review: Patient Falls

Medical Malpractice

“Medical malpractice” is a legal term that refers to negligent treatment, or failure to take appropriate action, on the part of a doctor or other medical practitioner that causes harm to a patient. An often rancorous partisan debate in the culture wars, the issue of malpractice suits has been labeled a “crisis” by the American Medical Association (AMA). In 1975, Newsweek magazine concurred, declaring malpractice “medicine's most serious crisis.” From 1960 to the mid-1980s, the frequency of medical malpractice claims in America rose from 1 to 17.5 per every 100 physicians. During the same period, plaintiff awards in major cities such as Chicago and San Francisco rose from $50,000 to $1.2 million. In addition to the specific repercussions for the medical community, insurance companies, and the overall cost of health care, the debate on medical malpractice has touched on larger issues of tort reform (Weiler, 1991).

According to the U.S. Department of Justice, in 2001 there were a total of 1,156 medical malpractice trials, including claims of permanent injury (67%) and death (33%). The overall success rate for plaintiffs was 27%, with a median award in jury trials of $431,000—up 50 percent from $287,000 just five years earlier. From 1992 to 2001, between 1 and 4% of successful plaintiff winners also received punitive damages, averaging about $250,000 per litigation. Many other cases were settled out of court (Danzon, 1985).

The AMA began earnestly addressing medical malpractice during the 1950s with the aim of reducing lawsuits by improving medical care, most notably by reforming hospital procedures and prompting standardization of medical records. (Of all malpractice suits at the time, 70% arose from incidents at hospitals.) Since surveys during that period found that most doctors did not consider medical malpractice lawsuits a major problem, AMA leadership began making them a topic of discussion in its Journal of the American Medical Association.

By the 1960s, the AMA shifted its focus of attack to the legal system, blaming the surge in malpractice lawsuits on lawyers and plaintiffs. During this period, rules pertaining to the statutes of limitations had been liberalized in favor of injured patients (that is, allowing a longer filing period for a malpractice claim since resulting health repercussions are not always initially known). Although there was a rise in the number of malpractice suits, it paralleled the increase in the number of physicians. The average award for medical malpractice in 1964 was $5,000, but several highly publicized cases gave successful plaintiffs windfalls of $100,000 or more. Malpractice suddenly became a high-profile public issue, covered in the mainstream press and made the subject of federal government inquiry. In November 1969, a subcommittee of the Senate Committee on Executive Reorganization issued a 1,060-page report on medical malpractice that asserted, albeit with no statistical support, “Most malpractice suits are the direct result of injuries suffered by patients during medical treatment or surgery. The majority have proved justifiable”. Critics questioned the claim of justifiability when 90% of malpractice cases that went ...