Skip to main content

An Introduction to Medical Malpractice in the United States


Medical malpractice law in the United States is derived from English common law, and was developed by rulings in various state courts. Medical malpractice lawsuits are a relatively common occurrence in the United States. The legal system is designed to encourage extensive discovery and negotiations between adversarial parties with the goal of resolving the dispute without going to jury trial. The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Money damages, if awarded, typically take into account both actual economic loss and noneconomic loss, such as pain and suffering.

This is a preview of subscription content, access via your institution.


  1. Boehm G. Debunking medical malpractice myths: unraveling the false premises behind “tort reform”. Yale J Health Policy Law Ethics. 2005;5:357–369.

    PubMed  Google Scholar 

  2. Bovbjerg RR. Malpractice crisis and reform. Clin Perinatol. 2005;32:203–233, viii–ix.

    PubMed  Article  Google Scholar 

  3. DeVille KA. Medical Malpractice in Nineteenth-Century America: Origins and Legacy. New York, NY: NYU Press; 1990.

    Google Scholar 

  4. Everad v. Hopkins, 80 English Reports 1164 (1615).

  5. Fisher TL. Medical malpractice in the United States: a review. Can Med Assoc J. 1974;110:102–103.

    PubMed  CAS  Google Scholar 

  6. Gittler GJ, Goldstein EJ. The elements of medical malpractice: an overview. Clin Infect Dis. 1996;23:1152–1155.

    PubMed  CAS  Google Scholar 

  7. Goldrich MS. Report of the Council on Ethical and Judicial Affairs. Washington, DC: American Medical Association; 2004.

    Google Scholar 

  8. Guirguis-Blake J, Fryer GE, Phillips RL, Jr., Szabat R, Green LA. The US Medical Liability System: evidence for legislative reform. Ann Fam Med. 2006;4:240–246.

    PubMed  Article  Google Scholar 

  9. Havighurst C. Private reform of tort-law dogma: market opportunities and legal obstacles. Law Contemp Problems. 1986;49:143–172.

    Article  CAS  Google Scholar 

  10. Hellinger FJ, Encinosa WE. The impact of state laws limiting malpractice damage awards on health care expenditures. Am J Public Health. 2006;96:1375–1381.

    PubMed  Article  Google Scholar 

  11. Hicks TC. William H. Harridge lecture: the medical malpractice crisis in surgery. Am J Surg. 2008;195:288–291.

    PubMed  Article  Google Scholar 

  12. Johnson KB, Phillips CA, Orentlicher D, Hatlie MJ. A Fault-based administrative alternative for resolving medical malpractice claims. Vanderbilt Law Rev. 1989;42:1365–1406.

    Google Scholar 

  13. Medical Malpractice Systems around the Globe: Examples from the US tort liability system and the Swedish no fault system. Washington, DC: World Bank. 2004. Available at: Accessed Oct. 13, 2008.

  14. Medical Malpractice. Implications of Rising Premiums on Access to Health Care. Washington, D.C. U.S. General Accounting Office. August 2003. Available at: Accessed Oct. 13, 2008.

  15. Mello MM, Brennan TA. Deterrence of medical errors: therapy and evidence for malpractice reform. Tex Law Rev. 2002;80:1628–1631.

    Google Scholar 

  16. Paterick TJ, Paterick TE, Waterhouse BE. The fundamentals of liability insurance: physician and organization perspectives. J Med Pract Manage. 2007;23:151–156.

    PubMed  Google Scholar 

  17. Peeples R, Harris CT, Metzloff TB. Settlement has many faces: physicians, attorneys and medical malpractice. J Health Soc Behav. 2000;41:333–346.

    PubMed  Article  CAS  Google Scholar 

  18. Powis Smith JM. Origin & History of Hebrew Law. Chicago, IL: University of Chicago Press; 1931.

    Google Scholar 

  19. Richards EP, Rathbun KC. Medical Care Law. Boston, MA: Jones & Barlett; 1999.

    Google Scholar 

  20. Roberts B, Hoch I. Malpractice litigation and medical costs in Mississippi. Health Econ. 2007;16:841–859.

    PubMed  Article  Google Scholar 

  21. Sloan FA, Bovbjerg RR, Githens PB. Insuring Medical Malpractice. New York, NY: Oxford University Press; 1991.

    Google Scholar 

  22. Speiser SM. American Law of Torts, Vol. 4, Sec.15.10. West; 1987.

  23. Upadhyay A, York S, Macaulay W, McGrory B, Robbennolt J, Bal BS. Medical malpractice in hip and knee arthroplasty. J Arthroplasty. 2007;22(6 Suppl 2):2–7.

    PubMed  Article  Google Scholar 

  24. White GE. Tort Law in America: An Intellectual History. New York, NY: Oxford U Press; 2003.

    Google Scholar 

Download references


I thank M.M. Manring, Ph.D., for his assistance in preparing this manuscript.

Author information

Authors and Affiliations


Corresponding author

Correspondence to B. Sonny Bal MD, MBA.

Additional information

The author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

About this article

Cite this article

Bal, B.S. An Introduction to Medical Malpractice in the United States. Clin Orthop Relat Res 467, 339–347 (2009).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Alternative Dispute Resolution
  • Medical Malpractice
  • Malpractice Claim
  • Jury Trial
  • Medical Negligence