Multimillion Dollar Costs Predicted in Screening Mammography Litigation

In just 10 years, the cost of screening mammography litigation in the United States could top $250 million a year, a recent analysis has found. The analysis, presented at this year’s American Roentgen Ray Society meeting in Atlanta, is based on a statistical model that reviewed the number of women likely to be undergoing mammograms, the potential for missed cancers, the average lawsuit settlement ($200,000 based on 1995 figures), and other similar factors.

"We are looking at a potential medical-legalmeltdown," said Richard Tello, md, msme, mph, professor of radiology,epidemiology, and biostatistics at Boston University. The baby boomers aregetting older, so the number of women needing mammograms is going up. As moremammograms are done, the potential for missed cancers increases, leading to anincreased chance of litigation.

Conservative Calculations

"We were conservative in our calculations—assumingthat only 1 in 10 women who are litigation candidates will sue, that half of thewomen who sue will have a lesion on a previous mammogram that was missed, andthat half of this subset will actually win their case," Dr. Tello said."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 theirlifetimes) would need to be saved beginning now, to pay these futurecosts," Dr. Tello said. "The $70 figure is based on conservativeestimates; using less conservative estimates, we found that the amount neededcould be as high as $200 per woman per mammogram."

This is a major problem, because some insurance reimbursementfor mammograms is just at or near the $70 level, Dr. Tello explained. At thisrate, it is not economically feasible for radiologists to contribute to alitigation pool. It is unlikely that insurance companies will pay more toprepare for future litigation costs. Malpractice insurance companies wouldlikely increase their premiums as litigation costs go up, making it lessattractive for radiologists to even do screening mammgraphy, he noted.

One Solution

In addition, it is unlikely that the patient will payout-of-pocket to support a litigation pool, Dr. Tello said. A solution, however,could be a federally sponsored litigation pool similar to the one that currentlyexists for vaccine lawsuits.

"The study indicates that we need to act now to avoid acrisis in 10 years, when the costs of litigation force the shutdown ofmammography facilities nationwide," he said.