This increase stands in stark contrast to most other areas of Pennsylvania, which have seen significant declines in malpractice suits since lawmakers passed reforms two years ago.

While the number of suits here nearly tripled, they fell 48 percent in Philadelphia, 46 percent in counties surrounding Lancaster and 32 percent statewide between 2000 and 2004.

To sharpen the local contrast, in 2004 and the first six months of this year, county residents filed 50 suits against doctors, hospitals and other health-care providers. For the previous four years combined, court records show only 27 malpractice suits here.

Local doctors and lawyers say it’s too soon to know if the increased number of malpractice suits is the beginning of a new pattern or merely a statistical oddity.

“We’ve noticed the trend,’’ said Dr. Anthony Mauriello Jr., president of the Lancaster City and County Medical Society, who has been named in several lawsuits. (See separate story.) “This could be a glitch on the screen, but it’s certainly concerning.’’

Either way, it’s important to note that the number of malpractice lawsuits remains low here in comparison to many other places.

In the same time period that Lancastrians filed 27 suits, Dauphin County residents filed 279 suits, York Countians 178 and Chester Countians 155.

Nonetheless, the recent surge in Lancaster County filings is real, and attorneys suggest that the same law that reduced malpractice cases elsewhere contributed to the rise here.

Attorney Robert Wee, president of the Lancaster Bar Association, believes more lawsuits are being filed here simply because, by law, they must be.

In early 2003, the state Supreme Court mandated that suits must be filed in the county, or venue, where the medical treatment occurred.

This venue-rule change was directed largely at plaintiffs who took their cases to Philadelphia, where juries are far more likely to favor large malpractice awards against doctors.

“In the past, cases were likely to be filed in Philadelphia,” said Wee. “Now they would be likely to be filed locally.’’

In fact, since that change took effect, the number of malpractice cases filed in Philadelphia has dropped by nearly 50 percent.

Two other factors may account for differing trends in the number of malpractice suits filed here and elsewhere, local attorneys say.

First, when the Supreme Court mandated the venue change, it also required a plaintiff to obtain a “certificate of merit’’ from a licensed medical professional stating that there is a probability that medical treatment caused harm to the patient.

This certification was designed to reduce the number of irresponsible lawsuits. Lawyers cite it as the primary reason that suits statewide have dropped so radically so quickly.

But “in Lancaster County we (plaintiffs’ attorneys) always would have had a responsible expert in the first place,’’ noted Lancaster attorney Joseph Roda.

“So the new certificate-of-merit rule didn’t affect the good lawyers but did affect the loose cannons in Philadelphia who might tend to file cases without doing the proper work-up.’’

Second, court records offices now may be keeping better count of medical malpractice cases.

Until 2004, cases were not designated specifically as medical malpractice.

Beginning last year, the Supreme Court directed plaintiffs’ attorneys to label such cases from the start.

So we know 32 medical malpractice cases were filed in Lancaster County in 2004. We do not know, for sure, the number of such cases filed here before then.

The Supreme Court told counties to go back and label malpractice cases for 2000-2003. That process was not perfect.

“Some cases probably fell through the cracks before because they didn’t show up during a manual search,’’ explained Lancaster County Prothonotary Randall Wenger. “The number we have registered now is probably more on par with the population.’’

The impact of the increased filings remains to be seen.

Not all of the 50 cases filed in the last year and a half will go to trial. Plaintiffs will drop some. Judges may dismiss others. Doctors may settle some cases out of court.

But a larger number of cases, all with expert certificates supporting them, may produce more jury trials than the six held here in 2004 and two so far this year — all proceeding from cases filed in 2003 or earlier.

Attorneys for plaintiffs look at increased filings one way.

William Atlee Jr., of Atlee Hall & Brookhart, a Lancaster firm that handles many suits against doctors, said the increase has occurred in part because “the performance of certain physicians in this community has caused a number of filings recently.’’

Doctors, and lawyers who represent doctors, view the increase another way.

James Saxton, of Stevens & Lee, a Lancaster firm that often defends doctors in malpractice cases, said if more malpractice filings do become a trend, “Of course it’s going to lead to a crisis. There is already too much stress on these medical practices.”