• S B Ransom, M P Dombrowski, R Shephard, and M Leonardi.
• Department of Obstetrics and Gynecology, Hutzel Hospital, Wayne State University School of Medicine, Detroit, Michigan, USA.
• Am. J. Obstet. Gynecol. 1996 Jun 1; 174 (6): 1903-7; discussion 1907-9.

ObjectiveOur goal was to evaluate the financial expenditures of the medical-legal tort system on the single largest medical campus in the United States.Study DesignThe true financial expenditures directed to the medical-legal system were determined and related to the total revenue and expenses of the Detroit Medical Center. All costs were determined, including malpractice premiums, paid claims information, accrual expense information, and risk management administrative expenses for the fiscal years 1992, 1993, and 1994.ResultsThe total medical-legal expenses for the years 1992, 1993, and 1994 were $73,732,000, $70,490,000, and $79,043,000, respectively. The claims paid to plaintiffs were 35.9%, 28.1%, and 28.1% for the same years.ConclusionThe medical-legal system process in the United States is very long and fraught with many inequities and inefficiencies. It was found that approximately 12% of the medical-legal expenditures of the Detroit Medical Center go to the individual alleged victim after defense and plaintiff attorney fees and costs and administrative costs. The failure of the American health care system could be in jeopardy if the nation's leaders do not reform the process to provide a more cost-effective system.

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