History of Litigation

Brief US history of medical malpractice litigation

Medical malpractice litigation in United States goes as far back as the 1794 case of Cross Vs Gunthrie. Although there were sporadic cases of medical malpractice litigation since, the medical malpractice crisis started in the early 1970’s and followed by a second crisis in the mid 1980’s. These crises are thought to be the result of: 1. increased incidence of malpractice litigation, and 2. increase in medical malpractice insurance premiums. In addition, the fact that new instrumentation, diagnostic testing, therapeutic modalities, and other technological advancements were incorporated into the armamentarium of physicians and surgeons made patients to expect prompt and accurate diagnosis and treatment. Patient’s perception of “medical care” changed from the “acceptance of inevitability of disease and death” to expectation of good health and longevity, and from “medical care” to expected cure. As a result by the early 1970’s there was little tolerance to iatrogenic (doctor caused) complications. In the late 1970’s and mid 1980’s in response to the medical malpractice crises states enacted legislations to ease the crises. These provisions included malpractice insurance regulation, measures addressing physician competency, and malpractice litigation reforms. Analysis of adverse medical events and medical malpractice claims (1990 Harvard Medical Malpractice Study, 1992 the Utah-Colorado Study) have shown that the number of medical malpractice claims were far less than the incidence of medical negligence. On the other hand it is well established, that unlike physicians in the rest of the world, the average American physician will be sued at least once during his/her career.