Published online October 1, 2007
PEDIATRICS
Vol. 120
No. 4
October 2007, pp.
933-934
(doi:10.1542/peds.2007-2137)
Malpractice Claims Involving Pediatricians
John M. Freeman, MD
Department of Neurology,
Johns Hopkins University,
Baltimore, MD 21287-7247
Andrew D. Freeman, JD
Brown, Goldstein & Levy, LLP,
Baltimore, MD 21202
To the Editor.—
Carroll and Buddenbaum1 are to be commended for bringing together information on the costs of malpractice claims against pediatricians. As they and others have indicated, malpractice continues to be a hotly debated issue that fails to serve its 2 main purposes: deterrence of negligence and compensation of those who suffer injuries. Although pediatricians only accounted for 
3% of claims, the mean indemnity payment was $261000, and costs for the 20-year period were more than $460 million.
Malpractice suits do not deter these events, and the amounts of money involved cannot adequately compensate for most of the suffering. The mean expense for defense of a pediatric case is now more than $40000, and expenses accounted for 28% of the indemnity costs. It should also be noted that one third to 40% of plaintiffs' recoveries go to their lawyers. There must be, and is, a better way.
A true no-fault system that compensates for the costs of injuries not covered by other existing programs could be administered by an independent agency at far less than costs of the current legal system.2 If the $40000 expenses of the current system were used to compensate for injuries rather than for defense of the cases, wouldn't society be better off? If the $15000 costs of defense attorneys and the $2700 of expert witness fees were awarded to the injured party, would that not be preferable? If the $85000 to $105000 of the average $260000 indemnity payments went to injured children rather than to their lawyers, would not the goal of compensation be better served?
Such a proposal was made in the 1980s2 but has been strongly opposed by plaintiffs' lawyers, who would be the only losers in such a system. A true no-fault system could partially compensate for injuries. An additional and separate review of claims could be used to discipline offending physicians.
Perhaps it is once again time to consider a no-fault compensation system,3 not just for birth-related injuries but for all alleged malpractice. Coupled with adequate discipline of offending physicians, a no-fault approach could accomplish the 2 main purported purposes of the current malpractice system at lower financial and emotional costs.
REFERENCES
- Carroll AE, Buddenbaum JL. Malpractice claims involving pediatricians: epidemiology and etiology.
Pediatrics. 2007;120
:10
–17[Abstract/Free Full Text]
- Freeman AD, Freeman JM. No-fault cerebral palsy insurance: an alternative to the obstetrical malpractice lottery.
J Health Polit Policy Law. 1989;14
:707
–718[ISI][Medline]
- Freeman AD, Freeman JM. No-fault birth-related neurologic injury compensation: perhaps its time has come again.
Harv Risk Manage Found Forum. 2003;23
:5
–6
PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics
