| California |
ID Medical Malpractice Cases. This is the only court-initiated reform. Medical Injury Compensation Act (MICRA) requires 90 days prior notice to commence medical medical malpractice action [Cal. Code Civ. Proc. 364(a)]; limits general compensatory (non-economic) damages to $250,000 (Cal. Civil Code 3333.2); allows introduction of evidence of certain collateral benefits (Cal. Civil Code 3333.1); limits contingency fee contracts in medical malpractice cases to 40% of the first $50,000 recovered, 33% of the next $50,000, 25% of the next $500,000, and 15% of excess over $600,000 (Cal. Business and Prof. Code 6146); provides for periodic payments of future damages (Cal. Code Civ. Proc. 667.7); authorizes compulsory arbitration agreements in medical service contracts (Cal. Code Civ. Proc. 1295). MICRA upheld, but $250,000 cap on non-economic damages does not apply to international torts. [Perry v. Shaw (2001) 88 CalApp.4th 658].
Arbitration. Not a court-initated reform.
Periodic Payment. Not a court-initiated reform.
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| Connecticut |
ID Medical Malpractice Cases. Civil Summons form (JD-CV-1) has field for case type; T28 IDs action as medical malpractice. ID of case type at writ entry and review of medical malpractice actions, not later than 6 months after filing, provide for early court intervention. (Reform reportedly works well.)
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
Pretrial Screening. Early screening conference pursuant to C.G.S. 52-190b, conducted to determine whether action should be referred to chief court admin. or chief admin. judge for designation as complex.
Specialized Docket.
Other. Individual calendar method use by Complex Litigation Docket; individual judge presides over all aspects of litigation, including trial.
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| Delaware |
ID Medical Malpractice Cases.
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
All reforms seem to work well.
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| Guam |
Arbitration. Legislature passed medical malpractice arbitration act, making arbitration mandatory for medical malpractices cases.
Other. Judicial review limited and costly to non-prevailing party; measure is reportedly too costly to be effective. Bar and Medical Society working w/ legislature to reform act; no compromise reached yet.
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| Hawaii |
ID Medical Malpractice Cases.
Penalities for Frivolous or Vexatious Claims/Defenses.
Arbitration.
Periodic Payment.
Structured Settlement.
Other. Medical claim conciliation panels; reporting requirement.
See State v. Montalbo, 73 Haw. 130, 828 P.2d 1274 (1992) and State v. Vliet, 95 Hawai'i 94, 19 P.3d 42 (2001).
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| Idaho |
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
Pretrial Screening. Reform reportedly works well.
Other. IC 9-207 makes inadmissible evidence of apology. Only court has authority to determine rule of evidence so statute has no effect; rules committee recommended rule that would adopt statute.
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| Iowa |
Penalties for Frivolous or Vexatious Claims/Defenses.
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| Kansas |
ID Medical Malpractice Cases.
Pretrial Screening. Medical grand jury, panel, etc.
Limit Liability. 2007 legislation enacted Sen. Substitute for HB 2451, which provides that Kansas Consumer Protection Act "does not allow for a private cause of action or remedy against licensed health care provider for causes of action for personal injury or death resulting, or alleged to have resulted, from medical negligence."
Other. Williamson v. Amrani, no. 95,154 2007 WL 419698 (Kan. Feb. 9, 2007), KS S.C. held physician providing care or tx can be found to have engaged in deceptive acts and practices in violation of KSA 50-626 and unconscionable acts and practices in violation of KSA 50-627 of Kansas Consumer Protection Act.
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| Maine |
Penalties for Frivolous or Vexatious Claims/Defenses.
Mediation. Reform reportedly works well.
Arbitration. Reform reportedly works well.
Pretrial Screening.
Other. Single justice for all civil actions.
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| Maryland |
ID Medical Malpractice Cases.
Affidavit/Certificate of Merit.
Mediation. Panel.
Other. Restrictions or qualifications of certifying and testifying experts. Admin. law system to process claims.
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| Massachusetts |
ID Medical Malpractice Claims.
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
Pretrial Screening.
Other. Every p. registered to meet directed verdict standard w/ offer of proof (exp. opinion) before medical malpractice tribunal. Those who do not must file bond. Tribunals screen out approx. 15% of cases. (Reform reportedly works well.) Court working with medical malpractice bar, MA Medical Society, and major institutions. Carriers on ideas to streamline and effectuate timely processing cases.
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| Michigan |
Entire State: Affidavit/Certificate of Merit, Mediation, Other (Facilitation and Case Evaluation [Both Reforms reportedly working well]).
Allegan: Affidavit/Certificate of Merit, Mediation (Reform reportedly works well).
Cassco: Affidavit/Certificate of Merit, Penalties for Frivolous or Vexatious Claims/Defenses, Mediation (Reform reportedly works well).
Chippewa: Affidavit/Certificate of Merit, Mediation, Arbitration, Structured Settlement.
Crawford (46th Circ.): Affidavit/Certificate of Merit, Mediation (panel).
Emmet: Affidavit/Certificate of Merit, Penalties for Frivolous or Vexatious Claims/Defenses, Mediation, Eliminate Collateral Source Rule.
Genesee: Affidavit/Certificate of Merit, Penalties for Frivolous or Vexatious Claims/Defenses, Mediation, Periodic Payment.
Hillsdale: Mediation (Reform reportedly works well).
Kalkaska (46th Circ.): Affidavit/Certificate of Merit, Mediation (panel).
Macomb: Mediation.
Marquette: Mediation, Specialized Docket (Both reforms reportedly work well).
Muskegon: Mediation.
Oakland: Affidavit/Certificate of Merit, Penalties for Frivolous or Vexatious Claims/Defenses, Mediation, Arbitration, Structured Settlement, Other (Cases evaluated; some sanction for rejection).
Otsego (46th Circ.): Affidavit/Certificate of Merit, Mediation (panel).
Ottawa: Affidavit/Certificate of Merit, Penalties for Frivolous or Vexatious Claims/Defenses, Mediation.
Saginaw: ID Medical Malpractice Cases, Affidavit/Certificate of Merit, Penalties for Frivolous or Vexatious Claims/Defenses, Mediation, Arbitration, Structured Settlement, Specialized Docket.
Shiawassee: Affidavit/Certificate of Merit, Mediation, Structured Settlement.
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| Minnesota |
ID Medical Malpractice Cases. State Supreme Court has written a number of opinions on statuatory requirements for exp. affidavits in medical malpractice cases (see annotations for Minn. Stat. section 145.682).
Penalties for Frivolous or Vexatious Claims/Defenses.
Mediation. Mandatory, non-binding ADR.
Reforms, except statutory medical affidavit requirement, were generic reforms aimed at more than medical malpractice. Have not performed any studies to determine impact. Impetus for mandatory, non-binding ADR was arguable statuatory. Reforms based in substantive law are discussed at every session of the legislature. No pending court-initiated reforms.
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| Mississippi |
Other. Limit venue and joinder in mass-tort and medical malpractice cases by court decision and rule amendments, esp. as relates to joinder of plaintiffs without state contacts. (Reform reportedly works well.)
Actions initiated by the court took place simultaneously with legislative "tort reform" and medical malpractice actions. Thus, it is difficult to determine the extent to which court initiatives have been responsible for any decline in mass tort/medical malpractice actions.
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| Montana |
Pretrial Screening.
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| Nevada |
Other. Senior judges conduct mandatory settlement conferences. This has been helpful getting conferences done quickly without disrupting district judges' calendars. (Reform reportedly works well.) No new initiatives planned. Nevada adopted comprehensive medical malpractice statutory scheme in 2002 based on Special Session and initiative of the people.
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| New Hampshire |
ID Medical Malpractice Cases.
Pretrial Screening.
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| New York |
ID Medical Malpractice Cases.
Affidavit/Certificate of Merit.
Pretrial Screening.
Structured Settlement.
Specialized Docket. Reform reportedly works well. Reportedly specialized dockets are "extremely effective. Justices assigned to medical malpractice parts have acquired expertise in the subject matter (for example, the proper scope of disclosure, the impact of HIPAA, and the proper valuation of cases). The constant court involvement in discovery and pre-trial procedures facilitates quick and proper disposition of cases."
Eliminate Collateral Source Rule.
Other. Specialized preliminary conference order formulated to speed medical malpractice cases. Currently expanding use of jury reforms to all medical malpractice trials including jury note taking; right of jurors to ask questions; giving copies of court's charge on the law and verdict sheet to each juror so they can follow charge as it is being given to them and take it into deliberation.
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| North Dakota |
Penalties for Frivolous or Vexatious Claims/Defenses.
Mediation.
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| Ohio |
Affidavit/Certificate of Merit. Further amendments to the affidavit of merit have to be adopted to clarify "good cause" for not providing the affidavit at the filing of the complaint.
Other. Limit venue.
Ohio's reforms have only been in use since July 1, 2005 and therefore have not been tested sufficiently to determine their usefulness.
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| Oklahoma |
Other. Cite lack of interest by bench and bar as reason for no new initiatives; noted that state legislature is the driving force behind tort reform.
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| Pennsylvania |
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
Mediation.
Periodic Payment. By statute not by rule.
Structured Docket.
Other. Limit venue; remittitur of excess damages for non-economic harm; expedited production of expert reports; case management ensures timely dispositions. (Reform reportedly works well.)
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| South Dakota |
Penalties for Frivolous or Vexatious Claims/Defenses.
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| Utah |
Mediation. But not specifically for medical malpractice.
Court itself has not initiated any reforms in the area of medical malpractice. That area is generally left to the legislature. Court has ability to issue reports on these survey questions but does not specifically track information for medical malpractice cases.
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| Vermont |
Mediation.
Arbitration.
Other. Court appoints each neutral evaluator unless parties go to ADR; pilot "sorry works". (Reform reportedly works well.)
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| Washington |
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
Mediation. Panel.
Arbitration.
Eliminate Collateral Source Rule.
Other. Limit the number of expert witnesses; limit number and length of depositions; 90 pre-suit notice.
Reforms noted above were initiated by the legislature rather than the courts. Legislative cap on non-economic damages in civil cases held unconstitutional.
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| West Virginia |
Affidavit/Certificate of Merit.
Penalties for Frivolous or Vexatious Claims/Defenses.
Mediation.
Eliminate Collateral Source Rule.
Limit Liability. Limit non-economic liability. Several (no joint) liability.
Other. Mandatory status conference within 60 days after appearance of defendant. Court may order summary jury trial.
All reforms seem to have worked well in that they have decreased media attention to these cases.
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| Wisconsin |
Mediation.
Arbitration.
Pretrial Screening. Nonbinding arbitration has reportedly not worked well because it is costly and time-consuming.
Limit Liability. Limit non-economic damages.
Other. Early neutral evaluation resolves some relatively low damage cases and helps ID where claimant unlikely to prevail on merits.
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