Here is an interesting study of med mal claims in this week’s New England Journal of Medicine (sub. req’d).
The abstract states (in part):
Results For 3 percent of the claims, there were no verifiable medical injuries, and 37 percent did not involve errors. Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy — nonpayment of claims associated with errors. When claims not involving errors were compensated, payments were significantly lower on average than were payments for claims involving errors ($313,205 vs. $521,560, P=0.004). Overall, claims not involving errors accounted for 13 to 16 percent of the system's total monetary costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including those involving lawyers, experts, and courts). Claims involving errors accounted for 78 percent of total administrative costs.
Conclusions Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant.
Here is a graphical representation of the study’s results. While the authors note that claims involving error account for 78 percent of total administrative costs, that implies that 22 percent goes to no-error cases. Using 2004 data (from the NAIC annual statement state page on defense costs) that would amount to almost $900 million of costs of claims without injuries. What would be interesting is to see if those no-error cases are randomly distributed among the states or if there were particular states with a higher incidence of no-error claims.