The number of medical malpractice lawsuits filed against Lancaster County physicians plummeted last year toward a level not seen here since 2003.

And no malpractice lawsuits went before Lancaster County juries in 2008.

The abrupt drop in malpractice filings and trials brings the county in line with statewide malpractice case decline that began in 2003.

Why the new trend?

Experts provide several reasons:

• Physicians are expressing more concern about their patients' negative outcomes.

• Hospitals are working to eliminate surgical and medication errors.

• Patients are reluctant to sue, juries are reluctant to convict doctors and attorneys are reluctant to take cases with damages under $1 million.

Only 13 cases were filed in the county Prothonotary's Office in 2008 and four of those cases already have been resolved. Three were dropped by patients; one doctor quickly settled a claim outside court.

That compares with 34 cases filed in 2007 and 40 in 2006.

After years in which many patients took cases to court and lost, no juries heard malpractice cases here last year.

Seven malpractice trials were held here in 2007 and juries ruled in favor of doctors in all of them. From 2000-2006, juries ruled in favor of doctors in all but five of 36 trials.

That doesn't mean doctors here aren't acknowledging liability for errors.

Local doctors' and hospitals' insurance companies have settled at least nine cases with patients outside court within the past year.

The abrupt decline in malpractice filings here does not reflect the more gradual annual reduction statewide.

Across Pennsylvania, 1,602 medical malpractice cases were filed in 2008, the Administrative Office of Pennsylvania Courts recently reported.

That compares with 1,641 in 2007 and 1,704 in 2006.

An abrupt decline in cases statewide first occurred in 2003, when the Pennsylvania Supreme Court adopted procedural changes designed to reduce malpractice cases.

Now all cases must be filed in the county where medical treatment occurred and must be certified by a medical expert.

Because of those rules, the number of cases statewide have been cut by 41 percent since 2000-2002, according to the Supreme Court.

Lancaster County's cases, trending in the opposite direction from 2004 to 2007, now are more in sync with the reduction statewide.

Local lawyers and doctors believe the sudden drop in malpractice filings here reflects several factors.

The Central Pennsylvania Physician Risk Retention Group has set "very aggressive risk management and patient safety standards for all of its physicians," says James Saxton, who has represented hospitals and physicians for 27 years with the Stevens & Lee law firm.

"Good communication between physicians and patients is really taking hold," he notes.

When physicians express concern about their patients' negative outcomes, he explains, patients are less likely to sue.

Reducing malpractice actions is good for doctors and the community, Saxton says, and he expects the trend to continue.

Dr. Karen Rizzo, president of the Lancaster City and County Medical Society, agrees.

"Improved communication can do nothing but help," she says. "Doctors want their patients to be happy and satisfied."

Rizzo also points to greater efforts being made by hospitals and surgery centers to eliminate surgery-site and medication errors.

Tom Hall, who has practiced personal injury litigation with Atlee, Hall & Brookhart for 26 years, has a different point of view.

Lancaster County is reverting to its well-known pro-doctor bias after a few years of high malpractice filings, he says.

"You need extremely clear liability and extremely compelling damages or you don't bring a malpractice case here," he says.

Hall says most lawyers won't pursue a malpractice case in central Pennsylvania unless damages are close to or exceed a million dollars because chances are a jury will turn down lesser claims.

He advocates a small claims court for malpractice cases that involve clear-cut medical negligence but smaller damages.

In addition, Hall says, "The doctors' lobby has done a real job of convincing people that the doctors' plight of being squeezed by the insurance industry is real."

An additional factor in reducing the number of malpractice lawsuits filed here is one doctor's responsibility for many cases. As the number of filings against Dr. Anthony Mauriello rose, so did the county's.

Mauriello, a Lancaster orthopedist, has been sued 27 times since 2002 — a period during which no other local doctor has been sued more than three times. (See separate story.)

All but four of the cases against Mauriello were filed between 2004 and 2007 — the years during which the county registered its highest malpractice numbers.

RELATED ARTICLE: Dr. Mauriello settles 9 suits

Staff writer Jack Brubaker can be reached at jbrubaker@LNPnews.com or 291-8781