Surgical liability cases drop nearly 80% at Texas medical center

Texas trauma surgeon Basil Pruitt Jr., MD, was confident the state's tort reform measures had reduced lawsuits at the medical center where he practices. But he and fellow physicians were shocked when they learned by how much.

A study published in the April issue of the Journal of the American College of Surgeons found a nearly 80% decrease in surgical liability lawsuits at the University of Texas Health Science Center at San Antonio since tort reform was enacted in 2003. That year, the Texas Legislature passed a comprehensive package of tort reforms that included a $250,000 cap on noneconomic damages in most medical negligence cases.

The lack of lawsuits led to a dramatic drop in legal costs at the center, the study showed.

"It confirmed our hypothesis that [tort reform] was important, but the magnitude of the decrease was quite striking," said Dr. Pruitt, one of the study's co-authors.

Researchers studied pre-tort reform surgery data at the medical center from 1992 to 2004 and analyzed surgeries performed post-reform. Of the 98,513 surgeries studied, 28 lawsuits were filed against residents or surgery faculty, the study showed. Twenty-five of the suits were filed before tort reform, and three were filed after reforms.

From 1992 to 2004, about 40 suits were filed for every 100,000 procedures. After reform, about eight lawsuits were filed per 100,000 surgeries. Legal costs, including settlements and jury awards, associated with lawsuits went from $595,000 a year to $515 a year post-reform.

The findings are in line with lawsuit reductions across the state after tort reform, said Rocky Wilcox, vice president and general counsel for the Texas Medical Assn. Data collected by the TMA show a 60% decrease in medical liability lawsuits in Texas since 2003.

Since the journal study was published, Dr. Pruitt has heard from other academic medical centers in Texas that have seen similar results. The study will encourage other states without tort reform to consider implementing such measures, he said.

"There are other states who have already taken notice and are taking the initiative to replicate it," he said.