Malpractice

Medical malpractice lawsuits cost $56 billion a year

Physician

May 26, 2026

Medical malpractice is big business in the United States. The only database monitoring medical malpractice is the National Practitioner Data Bank (NPDB). The NPDB’s annual report claims only 13,000 medical malpractice lawsuits. The NPDB was first established by the Health Care Quality Improvement Act in 1986. It was created by politicians (attorneys) for the express purpose of tracking specific adverse actions against health care practitioners.

Only 13,000 lawsuits are hardly “big …

The hidden cost of medical malpractice litigation

Gerald Kuo

Conditions

May 23, 2026

The emergency department was bright after midnight. An older man in his 80s arrived short of breath and frightened, surrounded by anxious family members. He had diabetes, chronic kidney disease, heart failure, and a recent fever. The nurse checked his blood pressure and tried to calm his daughter. The physician reviewed the chart and knew immediately: This would not be a simple night.

In medicine, we often work in the gray …

How a diversionary legal strategy harms medical malpractice

Howard Smith, MD

Physician

May 15, 2026

A set of medical malpractice cases can be presented as examples of a legal strategy that may undermine a fair trial. In Case A v. Medical Center A, a 16-year-old girl conceives in and lives in a developing country until 17 weeks of gestation and receives no prenatal care until 20 weeks of gestation, when she arrives in the United States. At that time, she is found to have chlamydia.

Other …

Medical apology laws don’t reduce malpractice lawsuits

Timothy Lesaca, MD

Physician

May 15, 2026

An apology after medical harm still matters, but perhaps not for the reasons medicine once believed.

For a long time, medicine saw apologizing after a bad outcome as risky or, at best, a way to protect oneself. Doctors were told to say as little as possible: Avoid guessing, don’t admit fault, and don’t apologize. This made sense in a legal system where lawsuits are common. But after a serious mistake, staying …

Medical malpractice risks persist even after saving a life

Chinmeri Nwuba

Policy

May 13, 2026

It is 2:17 a.m. in a crowded emergency room. A patient is rushed in. The patient is unconscious, unstable, and rapidly deteriorating. There is no time to obtain a detailed medical history, no opportunity for a careful discussion of risks, and obviously no time to seek consent. The doctor decides to take immediate action which saves the patient’s life. Weeks pass. The same doctor is served with a lawsuit.

At first …

Unavoidable pressure ulcer claims live and die by the record

Tracy Liberatore, Esq, PA

Conditions

May 11, 2026

Scenario: A resident develops a stage 4 pressure ulcer after admission to a long-term care facility. Plaintiff counsel argues the facility failed to prevent it. Defense counsel argues the ulcer was clinically unavoidable. Both positions hinge on the same federal regulation. The question is what the regulation actually says, and how the medical record measures up to it.

To work through this one, it is time for a history lesson. Travel …

How medical malpractice cases reveal health care system flaws

Howard Smith, MD

Physician

May 7, 2026

Again, I must discuss two cases of medical malpractice which I feel best demonstrate the quagmire our health care system finds itself in. One is a medical malpractice case against a hospital. It follows that this case also has a merit of only 33.48 percent. Nevertheless, there is a legal strategy that tips the scale by not permitting testimony discussing conditions occurring in another country, where the first 17 …

Medical expert witness report language gets cases struck

Tracy Liberatore, Esq, PA

Conditions

May 4, 2026

If you think one word inside a medical expert report cannot break a case, look at what happened in Kline v. Zimmer. A defense expert testified about possible alternative causes of a plaintiff’s injury, not probable ones. That single word, possibly, is the reason opinions like his are routinely challenged. Across multiple jurisdictions, courts have held that an expert who testifies in possibilities is offering no evidence at all.

In civil …

The cost of chaos in medical malpractice litigation

Howard Smith, MD

Physician

April 29, 2026

If anything represents the economic effects of medical malpractice, it is the following two cases. One involves a teenage mother and a major academic medical center. According to attorneys on both sides, the lawsuit is legitimate. However, its underlying merit is described as only 25.3 percent. Nevertheless, a legal strategy obscures this. The mother is 16 years old when she conceives and lives in a West African country until 17 …

Why experiential consent is replacing traditional medical consent forms

Ron Tongbai, MD

Physician

April 23, 2026

Imagine sitting in a witness box while a plaintiff attorney holds up your drafted, 15th-grade surgical consent form. You know the patient signed it. You know you spent 10 minutes explaining the risks. But then the attorney asks the patient: “When the doctor warned you about positive dysphotopsia, did you know it meant you wouldn’t be able to drive your grandchildren home at night?” The patient cries. The jury glares …

Medical expert testimony vs. advocacy in the courtroom

Howard Smith, MD

Physician

April 20, 2026

In Opinions, which is section 9.7.1 of the American Medical Association (AMA) Code of Medical Ethics, a physician serving as an expert witness has a duty to act as an objective, independent professional whose opinions are based on science, and not act as an advocate whose opinions win lawsuits. The question, which I now raise, is: “Are opinions expressed by a medical expert, which have 95 percent confidence (the …

The evolving standard of medical weight loss and obesity treatment

Howard Smith, MD

Conditions

April 12, 2026

Obesity is an epidemic. Obesity, the predispositions for obesity, and the medical consequences of obesity are a major, if not the major, contributing factors to most medical conditions that plague American society. This is true for everything, including cancers. For instance, how many people smoke in the mistaken belief that smoking controls appetite, and how many cancers have obesity as a risk factor? There are genetic …

Physician legal protection: Surviving academic medical center blame

David M.H. Lambert, DDS

Physician

April 6, 2026

On October 20, 2015, I did something unremarkable: I turned on the GPS app on my Android phone before driving to work. I had no idea that routine act would one day save my career and expose a pattern of institutional behavior that every academic physician needs to understand.

I was an assistant professor of oral and maxillofacial surgery at a major academic medical center. Two days after a high-risk patient …

Why clinicians fail at writing expert reports

Tracy Liberatore, Esq, PA

Conditions

April 3, 2026

I want to tell you something attorneys already know but will never say to your face. When your expert report lands in their inbox and they read it, I mean really read it, they know within the first two paragraphs whether they are calling you again. Not after the case. Right then. And if the answer is no, they do not tell you. They do not give feedback. They do …

The dysfunctional medical malpractice marketplace and tort reform

Howard Smith, MD

Physician

March 29, 2026

Nationwide, 200,000 lawsuits are filed per year. Among them are between 66,000 and 85,000 medical malpractice cases; however, this number is uncertain. Between 22,000 and 44,000 of these culminate favorably for the plaintiff as a settlement or a verdict. The remainder, two-thirds of all malpractice claims, are dropped or otherwise end favorably for the defendant. These statistics suggest that many medical malpractice claims are frivolous yet are still represented, and …

The mathematics of merit: Quantifying bias in medical malpractice

Howard Smith, MD

Physician

March 11, 2026

Most medical experts in medical malpractice are influenced by bias. Yet, they produce a certificate of merit. There are many types of biases, but I concentrate on only those biases that represent a systematic distortion that directly undermines the reliability of certainty in data and are measured by Type I and Type II errors.

Under this circumstance, merit can be regarded as certainty minus those biases. Those biases are selection bias, …

The future of U.S. medicine: 10 health care trends in 2026

Richard E. Anderson, MD & The Doctors Company

Physician

March 6, 2026

Predicting shifts in the health care environment has always been difficult, but this year, the pace of change, driven by regulatory complexity, mounting financial pressures, and artificial intelligence (AI), makes long-term forecasts increasingly uncertain. Each year, TDC Group has predicted emerging health care trends over the next decade, focusing on the challenges, risks, and opportunities that shape the industry. …

Understanding the 4 models of health care: Where the U.S. fits

Howard Smith, MD

Physician

February 19, 2026

We are frequently told that our health care system is expensive. However, most of us, including physicians, have no notion about what the health care system really is, to judge whether or not we are getting our money’s worth.

There are four major structural models for a health care system:

The Beveridge model (socialized medicine): Health care is provided and financed by the government through tax payments (e.g., United Kingdom’s NHS).

…

Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

Arthur Lazarus, MD, MBA

Conditions

February 15, 2026

As reported in the Philadelphia Inquirer, Louis-Hunter Kean was 34 years old when he died in November 2023 at the Hospital of the University of Pennsylvania (HUP). For more than a year, he endured cyclical fevers as high as 104.5 F, drenching night sweats, profound fatigue, hepatosplenomegaly, cytopenias, and escalating inflammation. Over six months in 2023, he was hospitalized five times. His electronic medical record ballooned to …

Tort reform medical malpractice: Why current laws fail

Howard Smith, MD

Physician

February 5, 2026

Tort reforms for medical malpractice preoccupy much of the legislative agenda for any state legislature as well as much of the time and budget of a state’s medical society. However, in truth, state legislators and the administrators of medical societies only care when it is to their advantage.

Because I am a physician in Maryland, I use Maryland as the example. In most states, tort reforms achieve six goals: