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" ;.:. : .: ,. :.....- , ~ ",..~." -..":" .. / "-., L_.~ - 2183-226858 p/ M~uLPRACTICE ARBITRATION: COMPARATIVE CASE STUDIES Final report on analysis of medical malpractice arbitration closed cases and comparison with litigation submitted by American Arbitration Association Research Institute November 1981 project supported in 1979-81 by Grant number 5 RO1 HS02654-03/04 ! National Center for Health Se~ices Research, Office of Health Policy., Research and Statistics Public Health Service Department of Health and Human Services • ," ~ . / --~.~f~. .fv.., ".- ---., . _.#~ . .~ . .- ..... : / .'; • '/".. "" 7 >" I .. _.I... .;- -. ". i ".L -j "'" - , , / " "'~.'~ "" " "" -" : _.o" .-.i/ ".- .... : ..- • .- ;, .- il ~0~" I~ [ IL ~EI~(}I~T DI~I~UI~IrI~TAT~I~I" s. ~om ~. pAGE l NCHSR 83-43 .':I rlovemb~.r 1981 I . , MALPRACTICE ARBITRATIO~I: COMPARATIVE CASE STUDIES Final Report • + Irving Ladimer, S.J.D. , ip. !0...~----t/'rms.~/~,,,.~ U~t COo. American Arbitration Assq~iation !1. C=~roctfC) o~ G,ro~(G) t~o. 140 West 51st Street (C) New York, NY 10020 i~i HS 02654 12. ~,ws,r'lr~ O,rSo~om ~ln*~q, I~ AdcS~ss DHHS, PHS, OASH, National Center for Health Services Research Final Repr~rt Publications and Information Branch, 1-46 Park Building 7/I/77 - 6/30/81 5600 Fishers Lane Rockvil}e, MD 20857 n~~.~)--The objectives of this study were to deve'lop a data base on medical ~al practice claims entering the arbitration iorum; and to compare the effects and effectiveness of arbitration versus litigation as a method of resolving ~,edical malpractice claims. Case files or surPmary data, such as insurer claim reports, were examined for approximately 300 closed arbitration cases believed to ~epresent the majority of cases closed nationally between 1970 and 1979. The large maiority of cases are from the California Hospital and Medical .~ssociation's arbitration program, flat included are data from cases resolved in arbitration under HMO or other prepaid group plan contracts. The arbitration data base v~as designed to yield informatlon. separately by claim-producing incident, by claim, by defendent or by forum. For comparative analyses, a litigation sample of 500 cases was obtained from :the National Association of Insurance Con~nissioners' (r~AIC) national survey representing insured r~d~cal malpractice claims closed between 1975 and 1978. The data base and ancil- la~'y materials, including the computer program, are available directly fr~ the American Arbitration Association. The Final Report presents a descriptive analysis of 205 cases closed in the arbitration forum; and, a comparative analysis of.a sample of arbitration and court cases occurring ir southern California. Because the information is limited in type and volu~e, and the comparison study is restricted to one area and program, this work is described as a pilot or ',~troductory effort. The findings should be considered indicative rather than definitive, a~,- cannot be generalized for other areas or even other arbitration systems. Given these cav(,: :s the major findings include: (I) arbitration appeared to be the more efficient method, ~s measured in terms of time for report and processing; (2) the two forums appear to be ~qu valent with regard to frequency and amount of indemnity award; (3) there was no evidence ~,~at arbitration produces compromise or favors one side over the other; (4) cases in arbitration were more likely to be adjudicated on the merits. 11. O,0¢~mee~ Anot,/.m~ J. Oeu:~pioes NCHSR publication of research findings does not necessarily represent approval or official endorsement by the r~ational Center for Health Services Research or the U.S. Department of Health and Human Services. James R. U11om, ;qCHSR Project Officer, 301/443-2080. Ir l~w~ i ~ l {~pi~ qr.n~4~l ymm~s :Health services research, malpractice, arbitration, HI, flY, legal IlL AvilJLm~lJl[7 -- Releasable to the public. Available from National Unclassified Technical Information Service, Springfield, VA ~,,~c~,~m~,8,) n.P,~ . ~i~i T~I • 7~)3/~R7-465fl Unclassified Sore A.NS~Z~r9.18) (For~y NTIS,.~S) Depa~ ~ ." * . ; ; ! "°" ,. " / s" M2~LP ~.CT ICE AP3 IT RAT IO.~ : COMPARATIVE CASE STUDIES by .° % Irving Ladimer, S.J.D. Program Director Research Institute American Arbitration Association Joel C. Solomon Research Associate Research Institute American Arbitration Association Michael Mulvihill, Dr. P.H. Depar~,.~ent of CoMmunity Medicine :4t. Sinai School of Medicine l.~& ... \ %., ?. • .. , .I .--~ . .,~--"" I / .L ......... ' " ! i I TABLZ OF CONTENTS Foreword ............................ 1 I. Medical Malpractice Arbitration: Legal and Program 3 Foundations ........................ \ A. ID'roduction ...................... 3 Definition ..................... 3 Comparison Between Court and Arbitration Systems. 5 • 7 Role ........................ 8 Sources of Cases ......... State and Regional'Plans. : • . : . : : : :I0 Characteristics ................... ii Heal~, Care Organizations ............. 12 Acceptance by Physicians .............. 12 Acceptance by Consumers ............... 13 B. Court Cases ................ ..14 Constitutionality and Application'of ~bi:rat:on Agreements .................... 14 Significant Cases ................ 20 Physician's Office Arbi~ation ........ : ..2~ Co~ent ....... ~ ............... 25 # If. Descriptive Analysis of Medical Malpractice Arbitration Experience ...................... .... 27 A. Introduction ..................... ~7 B. Cc~position of Cases in Data Base ........... ~9 C. Concept of Forum .................... 30 D. The Analytic Theme .................. ~l E Th Data