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Medical malpractice · United States · state-level data

The Geography of Medical Malpractice

Where malpractice dollars are paid, how large the average award is, and how each state's damage-cap law reshapes the picture. Hover or tap any state.

Read this before you read the map: what NPDB leaves out. Every number here is real and sourced, but the source has two structural blind spots, and together they hide almost the entire nuclear-verdict tail.
  1. NPDB records payments, not verdicts. A jury number is not a transfer of money. Remittitur, appeal, statutory caps, post-trial settlement and defendant insolvency all cut it, often to a fraction.
  2. NPDB only covers payments made on behalf of a licensed practitioner. A payment resolving a claim solely against an entity — a hospital, health system, clinic or group practice — with no individual practitioner identified is not reportable at all (NPDB FAQ). The largest awards are disproportionately against health systems, so the biggest cases are the ones most likely to be missing. Defense counsel dismissing the named physician before settlement so the payment lands entirely on the corporation — the “corporate shield” — is a documented practice.
So this is an accurate map of routine, practitioner-level malpractice payments, and it is not a map of malpractice verdicts. The tail it cannot show is charted further down. There is also no national registry of malpractice lawsuits filed and no nationwide county-level series; NPDB begins in 1990.

Why average award, not total, is the interesting map

Total payouts and report counts mostly track population — New York, Florida, and California lead because they are large, which tells you little. The revealing layer is average payment per report next to cap law. States that cap non-economic (“pain and suffering”) damages tend to sit lower on average award; states where caps were struck down or never existed sit higher. Indiana — long the most heavily cap-structured state — posts the lowest average in the country ($0.21M), while several no-cap and high-cap states cluster near the top. The map lets you see that relationship rather than assert it.

It is not a clean law of nature — North Dakota's tiny caseload produces a volatile average, and case mix (a few catastrophic birth-injury cases) can lift a small state — but the pattern is visible, and it is the honest version of the story.

The tail this map cannot show

A fair objection to everything above: where are the nuclear verdicts? They are not here, and the reason is not that they did not happen — it is that NPDB is structurally incapable of recording most of them.

Utah is the cleanest demonstration. On this map Utah looks unremarkable and cheap: 66 payment reports, $22.89M paid all year, a $0.35M average, a $450,000 cap. In August 2025 a Utah court entered a $951 million judgment against Steward Health Care over a 2019 birth injury — the largest medical malpractice award in the state's history, roughly 41× Utah's entire reported annual payments. It appears nowhere in the data above, for both reasons at once: it is a judgment rather than a payment, the defendant is a health system rather than a named practitioner, and Steward is in bankruptcy owing billions, so counsel are hoping to recover the punitive portion alone.

Below are documented $10M+ medical malpractice awards from 2025 and early 2026. The thirteen from 2025 alone total $1.29B — against $4.56B in all NPDB practitioner payments nationwide that same year — and this is a sample, not a census. TransRe counted 57 medical malpractice verdicts of $10M or more in 2023 alone, and the average of the top fifty rose from $32M in 2022 to $48M in 2023 to $56M in 2024. Philadelphia and Pennsylvania have ranked first on ATRA’s Judicial Hellholes list, and produce more $10M+ verdicts than any table this size can hold.

The Pennsylvania entry is worth reading closely, because it cuts against the usual framing of these awards. $106.1M of that $108.6M verdict is future medical care — a life-care plan for a child with a 68-year life expectancy — not pain and suffering, and not punitive damages. Large is not the same as arbitrary, and the composition of an award tells you which one you are looking at.

StateAwardWhenCaseDefendant
UT$951MAug 2025Birth injury; two nurses still in orientation, on-call physician asleep. Default judgment after Steward's counsel withdrew.health system
PA$108.6MMar 2026Birth injury after forceps delivery; brain damage. $106.1M of the total is future medical care over a 68-year life expectancy. Defendant is appealing.health system
GA$70MApr 2025Medication overdose and sepsis mismanagement; bilateral amputations.practitioner
NY$60MMay 2025Improper epidural steroid injection; spinal cord infarction and paralysis.practitioner
FL$45MApr 2025Cardiac patient admitted without urgent cath capability, then transferred with delay; died on arrival.health system
WI$29MMar 2025Nurse midwife did not act on fetal heart-rate decelerations; cerebral palsy.practitioner
GA$25MMar 2025Preeclampsia mismanaged and patient improperly discharged; unborn child died.practitioner
OR$20.6MMar 2025Unsterilized implants caused infection; ended a professional athletic career.practitioner
MA$17MJan 2025Bowel perforation not identified after elective hernia surgery; patient died.practitioner
NM$16.75MJan 202513-inch metal retractor left in the abdomen for 58 days.health system
SC$16MMar 2025C-section delayed despite fetal distress; newborn died.both
GA$15.5MApr 2025Teleradiologist misread a CT; quadriplegia, then death.practitioner
GA$13.75MFeb 2025Excessive anesthesia dose; respiratory failure not recognized.both
WI$10.2MFeb 2025Excessive Pitocin during labor; brain damage.practitioner

Awards as returned by the court, before remittitur, appeal, caps or settlement — several will be reduced substantially, and some will never be collected. That is precisely the point: the verdict number and the payment number are different quantities, and only the second one is mapped above. States carrying one of these awards are marked with a on the map; select the state to read them.

Maps this data can — and can't — support

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