Yesterday I wrote about the decrease in the number of medical malpractice case filings since the new law requiring pre-suit notice and a certificate of good faith went into effect October 1,2008. As I mentioned, the total number of medical malpractice lawsuits filed for the one-year period ending September 30, 2010 was 313.
Tennessee has approximately 6,100,000 people. Assuming that there was a single plaintiff in each case (which is almost always true except for loss of consortium claims in injury cases) simple math tells us that there was one claim filed for every 20,000 Tennesseans.
There are 137 hospitals in the state with about 20,000 hospital beds. There are 317 nursing homes with 36,276 beds. There are about 18,560 non-federal licensed physicians. There are also almost 62,000 registered nurses. There are 954 physicians’ assistants, 4853 nurse practitioners and 4,196 dentists. Each of these providers is a potential defendant in a malpractice case. Add to this some number of x-ray techs, ambulance drivers, etc.
Now remember: there were only 313 medical malpractice suits actually filed for the year that ended September 30.
Of course, we don’t know how many health care providers were sued in each case. Many cases involve only one provider, but it is true that a good number of cases involve multiple providers, especially because one provider who was sued will assert that a health care provider who was not sued committed medical malpractice and needs to be added as a party defendant.
Even if there are an average of three providers as defendants in medical malpractice cases (a number that is probably high) there are relatively few health care providers sued given the number of health care providers.in Tennessee.
I would be willing to bet that every single hospital risk manager in the state has incident reports in his or her desk drawer that are clear cases of malpractice that never result in claims. Indeed, I will go further and say the number of meritorious cases that each hospital in the state has actual knowledge of (through incident reports) exceeds the number of cases actually filed against the facility by a factor of five or more.
How can I say this with any confidence? The Institutes of Medicine told us over a decade ago that 98,000 people die per year from medical malpractice in our hospitals. Tennessee has about 2% of the nation’s population. Thus, about 2000 people die in Tennessee every year from malpractice in hospitals.
As I said above, there were 313 claims filed last year. Those claims were not just death claims – they were injury and death claims. My guess – a guess based on almost 30 years of work in this area – is that there are more injuries caused by medical malpractice than there are deaths from malpractice.
In any event, if 2000 Tennesseans died from malpractice in a given year and there are about 300 death and injury cases filed that year, that means that no less than 1700 valid death cases were not filed. I am not saying that they should have been filed – families with valid cases have every right not to pursue a case. I am saying that there were valid death cases that could have been filed and that there were thousands of valid injury cases that were not filed.
One might legitimately ask this question: Does Tennessee have a problem with too many medical malpractice cases that find their way to the judicial system? Or too few?
More on this subject next week.
Note: all data concerning numbers of hospitals and health care providers is 2008 data. See the source here. There is no reason to believe that the data has changed materially.