radiologist as a defendant or making reference to a radiologic procedure in the legal complaint was documented and analyzed. These lawsuits were then categorized so that a 20-year longitudinal evaluation could be made to determine meaningful trends. Each lawsuit listing in the Verdict Reporter includes the names of all plaintiffs and defendants, a narrative of the incident, and the specific allegations of negligence. Our data, therefore, reflect preliminary grievances only and do not contain additional facts elicited during subsequent legal discovery procedures or final disposition of the cases. Attempts to obtain details on the ultimate resolution of lawsuits were not fruitful, for although court trials are public record and information on verdicts and damages awarded is easily obtained, assess- ment of liability and monetary payments agreed upon by the parties in settled cases are not generally disclosed. National publications that list medical malpractice settlements are anecdotal and contain data usually obtained from attorneys who selectively volunteer such information. Sporadic reports of settlements reach the news media from time to time, but the fact remains that the terms of most settlements are not recorded publicly and hence are simply not available. Frequency of Malpractice Table 1 lists all of the 18,860 malpractice suits in Cook County from January 1, 1975, through December 31, 1994, naming as at least one codefendant a medical or osteopathic physician. Lawsuits filed against only hospitals, dentists, podiatrists, or other professionals are not included in this study. We selected 1975 as the starting point, as that was the year in which the medical malpractice problem became a full-blown crisis in the public eye because of threats by various malpractice insurance carriers to terminate physician cover- age [3]. Although medical malpractice litigation in the United States has been occurring since the mid 19th century, no central source of malpractice claim data existed until the mid 1970s. As can be seen in Figure 1 , the total number of medical malpractice cases filed in Cook County rose dramatically annually from 1975 to mid 1985, when the number dropped precipitously. This sharp decrease was attributed to major tort reform measures by the Illinois legislature [21. From a low of 492 in 1986, the year following tort reform, the num- ben of annual lawsuit filings has resumed a moderate but steady rise. In 1994 the number of lawsuit filings reached 1197, still less than half the cases filed in 1985. The proportion of medical malpractice cases relating to radiology appears steady throughout the 20- year time span, ranging from 10% to 15%, with an average of 12%. The twe prevalence of medical malpractice and malpractice claims among physicians cannot be discerned from our data but has been addressed by others. Brennan et al. [4] reviewed 31 000 hospital records and found adverse events in 3.2% of them; negligence was presumed to be responsible for one fourth ofthese. A 1972 survey disclosed that 12% of radiologists had been involved in malpractice litigation over the previ- ous 10 years [5]. Brenner [6] estimated that more than 40% of the nation’s practicing radiologists have been sued at least once in their career since 1987. In Texas, 38% of radiologists were sued in one year alone, 1992 (up from 22% in 1988) [7]. The percentage of Cook County’s radiologists sued since 1975 is unknown, for even 7% 163 Downloaded from 2600:1700:3c30:a3d0:f906:a606:b80b:7d98 on 07/20/22 from IP address 2600:1700:3c30:a3d0:f906:a606:b80b:7d98. Copyright ARRS. For personal use only; all rights reserved FIg. 1 .-Number of medIcal malpractice lawsuits, and those related to radiology, Cook County, IL, 1975-1994. Fig. 2.-Radiology-related lawsuits in Cook County, IL, 1975-1994, divlded into six categories, grouped In four 5-year Intervals. AJA:165, October 1995 MALPRACTICE AND RADIOLOGISTS 783 ben of lawsuits and radiologists is documented, many radiologists have faced multiple claims; others have died, retired, or moved; and a considenable number of new radiologists have entered practice. The Costs of Malpractice The cost of medical malpractice is substantial. Of a total annual national medical expenditure of $800 billion, medical malpractice costs are estimated to be $9 billion [8]. Malpractice claims resulting in indemnification payments have been rising annually [9], as has the average cost per malpractice claim paid [1 0]. Median verdicts hovered in the $200,000 range in the early 1980s, then rose to $300,000 in the late 1980s, and have exceeded $400,000 in the 1990s [11]. According to a study by the Physician Insurers Association of Amenca, insurance payouts for radiology in 1993 averaged $104,000, accounting for 6% of all medical malpractice claims paid [12]. Although these figures do provide a reasonable barometer of medical malpractice costs, they remain incomplete, as malpractice cases are being settled out of court at a greater rate than in the past [13]. Results and Discussion Slip-and-Fall Injuries Slip-and-fall is a term commonly used by risk managers, attorneys, and insurance personnel to describe those lawsuits filed by patients claiming injury as a result offalling off examination tables, chairs, or carts; slipping on floors; tripping oven funniture; or being inadvertently struck by equipment or