Folks who live in Lancaster County often like to say they are "not the kind who sue."

But they seem to be suing their doctors left and right.

Medical malpractice lawsuits filed here are increasing faster than in any other Pennsylvania county.

Local residents filed just 11 malpractice suits in 2000 and a mere two in 2001.

By contrast, aggrieved patients here filed 40 claims last year. And the 16 suits filed so far this year are running slightly ahead of that pace.

Advocates for local physicians are concerned.

"More cases are being filed. That's clear," notes James Saxton, chair of the physician-friendly health litigation group in the  Stevens & Lee law firm's Lancaster office.

"I hope that the culture in Lancaster County is not changing, because I think that would be unfortunate for our community. I hope statistics like these do not in any way tend to make it harder to recruit great physicians."

Doctors who have been sued should be concerned, notes Tom Hall, an attorney with Atlee, Hall & Brookhart, a Lancaster law firm that represents a number of patients in malpractice cases.

"Most of these cases will be settled," he says.

"The long shots go to trial. The rest typically get resolved in favor of the plaintiff. If we file a case, we're going to take it to verdict or settlement."

Hall says most malpractice cases are settled when doctors agree to pay a negotiated sum to the patient. Last year, only six cases went to trial here.

But Saxton counters that physician-initiated settlements are "not by any stretch the majority of these cases" and that many lawsuits are dismissed in the physicians' favor.

Either way, the growth in malpractice claims is drawing the attention of the county's doctors and lawyers.

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Statistics recently released by the Administrative Office of the Pennsylvania Courts show that malpractice cases filed here in 2006 increased a startling 446 percent above the average annual number of cases filed in the first three years of the decade. That was the highest percentage increase among all the counties in the state.

The rising number contrasts sharply with the experience in most other parts of Pennsylvania, which have seen significant declines in malpractice claims in recent years.

Statewide, case filings plummeted from 2,600 in 2000 to 1,700 in 2006. They registered a 38 percent drop from 2000-2002 to 2006.

Why are Lancaster County's malpractice filings moving in the opposite direction?

One reason is stricter Supreme Court rules that took effect in 2003. They required that most malpractice claims be filed in the county where the medical treatment occurred.

That prevented patients from taking cases to Philadelphia, where juries are more likely to favor large malpractice awards against doctors.

As a result, the percentage of cases filed in Philadelphia dropped 53 percent from 2000-2002 to 2006. Some of the cases that might have been filed there  may have been filed here instead.

But that does not fully explain why Lancaster County residents are bucking the statewide trend toward filing fewer medical suits.

Moreover, this area's experience is also running counter to the situation found in other counties in the region.

Malpractice cases by percentage declined in all counties surrounding Lancaster from 2000-2002 to 2006. In York County, they fell 92 percent. In Chester County, 12 percent.

Why is the record here so different?

"We may have had some false lows before (the Supreme Court rule changes)," notes Stephanie Mackey, president of the Lancaster City and County Medical Society.

"Now you don't know," she says, whether the increase in cases represents more dissatisfied patients or  a shift in where the cases are being filed.

But Saxton believes the increase is real.

"More patients, instead of going to their doctor and talking to them about what happened, which I would always encourage, are going to a lawyer," he says. "We do have a large number of lawyers who specialize in medical malpractice."

Hall believes malpractice cases  historically were "abnormally low" here but that an influx of former residents of the Philadelphia area has offset residents who do not believe in filing lawsuits.

"I think the stigma of suing a doctor is going away," he notes, "and people are just more aware of health-care information. The Internet is a huge tool in that regard."

The county's increasing population and the growth of medical activity, especially at Lancaster General Hospital, also are factors in the increasing number of claims, notes Jeffrey Reich, president of the Lancaster County Bar Association.

"That rising percentage (of malpractice cases) doesn't necessarily mean we have a negligent medical community or a legal community that is hot on their trails," says Reich.

In fact, the number of malpractice cases filed last year was in line with the population. Lancaster County is the state's sixth-most populous, with the eighth-highest number of medical lawsuits. In 2000, this county also was the sixth-most populous but 28th in number of suits.

On a per-capita basis, Philadelphians were nearly five times more likely than local residents to sue doctors in 2006, while York County residents were eight times less likely to sue compared to people who live here.

One significant contributor to the growth in malpractice claims here is Dr. Anthony Mauriello, a Lancaster orthopedist who was sued 17 times from 2004 through 2006.

Removing the 11 suits filed against Mauriello from the 2006 total leaves 29. But even that number represents nearly a 300 percent increase from the 2000-2002 average and maintains this county among the top three that registered increases in the state during the period.

Saxton points out that more claims have produced neither more trials nor more doctors found  negligent by juries.

Of seven malpractice cases that went to trial here in 2004, only two juries ruled against the doctor involved. In 2005, two of six trials were decided against the doctor. Last year, one of six juries found the doctor medically negligent.

"We have not seen an increase in true malpractice cases," says Saxton. "When we get these cases reviewed by top-flight experts, on a consistent basis they say the result may be unfortunate, but the care is appropriate."

But Hall says that is not his experience.

"All of these cases have some degree of merit," he says. "I can't recall dropping a case after filing a complaint. The majority of these cases wind up in some form of payment to the plaintiff."

CONTACT US: jbrubaker@LNPnews.com or 291-8781