Analysis Predicts Multimillion-Dollar Litigation Costs in Screening Mammography

April 30, 2002

NEW YORK (MedscapeWire) May 01 — In just 10 years, the cost of screening mammography litigation in the United States could top $250 million a year, a new analysis has found.

The analysis, presented at the American Roentgen Ray Society annual meeting on April 29 in Atlanta, Georgia, is based on a statistical model that reviewed the number of women likely to undergo mammograms, the potential for missed cancers, the average lawsuit settlement ($200,000 based on 1995 figures), and other related factors.

"We are looking at a potential medical-legal meltdown," says Richard Tello, MD, MSME, MPH, professor of radiology, epidemiology and biostatistics at Boston University in Massachusetts, in a news release. Because a large group of people are growing older at the same time — baby boomers — the number of women needing mammograms is going up. As more mammograms are performed, the potential for missed cancers increases, leading to an increased chance of litigation.

"We were conservative in our calculations — assuming that only 1 in 10 women who are litigation candidates will sue, that half of the women who sue will have a lesion on a previous mammogram that was missed, then half of this subset will actually win their case," says Dr. Tello. These litigation costs could potentially go even higher, he added.

"The analysis found that $70 per woman per mammogram (assuming that about half of eligible women would have 20 mammograms over their lifetimes) would need to be saved beginning now to pay these future costs," says Dr. Tello. "The $70 figure is based on conservative estimates; using less conservative estimates we found that the amount needed could be as high as $200 per woman per mammogram," he says.

This is a major problem because some insurance reimbursement for mammograms is at or near the $70 level, says Dr. Tello. At this rate, it is not economically feasible for radiologists to contribute to a litigation pool. It is unlikely the insurance companies will pay more to prepare for future litigation costs.

Malpractice insurance companies would likely increase their premiums as litigation costs go up, making it less attractive for radiologists to do screening mammography, says Dr. Tello. In addition, it is very unlikely the patient will pay out-of-pocket to support a litigation pool, he says. A solution, however, could be a federally sponsored litigation pool similar to the one that currently exists for vaccine lawsuits, Dr. Tello says.

The study indicates that action is needed now to avoid a crisis in 10 years, when the costs of litigation force the shutdown of mammography facilities nationwide, says Dr. Tello.

The study was conducted in conjunction with Bethany Richman, MD, and the Boston University radiology department's predictive modeling group.

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