While cross-market mergers may lead to competitive advantages, each geographic market has its own risk considerations. Healthcare claims frequency and severity varies across the U.S. depending on the litigation culture and laws in each region. For those considering a merger or
acquisition in the healthcare market, it is essential to know where greater instances of healthcare professional liability have been reported. Here is a comprehensive view of the top six states with the most reported nuclear verdicts — where plaintiffs have received damage awards of $10
million or more — from January 2016 to July 2023,(1) and their impact on healthcare professional liability.
- Georgia
Georgia recently claimed the top spot in the American Tort Reform Foundation’s annual list of challenging litigation districts for defendants,(2) in large part due to its massive nuclear verdicts and liability expanding rulings, which forces defendants to pay as much as double the plaintiffs’ attorneys’ fees if they lose.
In the 2010s, 53 nuclear verdicts were reported in Georgia, totaling $3 billion in awards for plaintiffs — and 21% of these verdicts were for medical liability claims.(3) Between January 2016 and July 2023, 23 nuclear verdicts with awards totaling $655 million(1) were reported in the state of Georgia.
Georgia is also one of a handful of states that have codified a rule allowing plaintiffs’ lawyers to seek any amount of damages for pain and suffering, “no matter how extraordinary.”(3) - Pennsylvania
Medical malpractice liability and product liability cases account for more than 60% of nuclear verdicts in Pennsylvania.(3) In 2022, the Supreme Court of Pennsylvania relaxed venue restrictions for plaintiffs’ lawyers filing medical liability lawsuits, no longer restricting venue to where the treatment occurred. This poses a risk to healthcare providers as lawyers can now choose jurisdictions where they expect a more plaintiff-favorable jury. Between January 2016 and July 2023, 23 nuclear verdicts issued $662.9 million in total awards in Pennsylvania.(1) - Illinois
Medical liability trials resulting in nuclear verdicts are nearly twice as common in Illinois as they are throughout the rest of the United States. Two-thirds of Illinois’s nuclear verdicts are issued by the Cook County Circuit Court.3 Between January 2016 to July 2023, 30 nuclear verdicts were reported, totaling $910.8 million in awards.(1)
Cook County is also a hot spot for Biometric Information Privacy Act (BIPA) cases. In February 2023, a ruling decided that BIPA claims accrue each time a biometric identifier is unlawfully collected and disclosed, rather than just the first time.(4) State healthcare organizations are particularly vulnerable as Illinois law requires them to perform fingerprint-based background checks on their employees. While a bill was filed in January 2023 to amend BIPA and carve out an exemption for healthcare employers, even under this change, healthcare employers would need to maintain strong operational practices to ensure they follow the proper procedures to remain exempt. - California
California’s A.B. 35 went into effect in January 2023, raising the $250,000 cap on noneconomic damages — otherwise known as pain and suffering — in medical liability cases to $350,000.(5) This legislation also provides for future increases that will eventually reach $750,000. Between January 2016 and July 2023, 14 nuclear verdicts awarded $465.1 million in total damages.(1) While only 7.6% of the state’s nuclear verdicts resulted from medical liability claims, this makes medical professionals more vulnerable to nuclear verdicts.(3) - New York
New York is one of the most challenging states for doctors due to high malpractice award payouts and expensive malpractice liability insurance rates.(6) With no cap on pain and suffering awards, New York lawyers are known to “anchor” or start with an extremely high figure when requesting an award. Unlike medical expenses, pain and suffering cannot be objectively measured, and this tactic often leads to nuclear verdicts. In fact, in 90% of cases where over $20 million is requested, at least that amount is received.(7) Between January 2016 and July 2023, 30 nuclear verdicts awarded $969.9 million in total damages.(1) - Florida
With the most nuclear verdicts per capita, and 40% including a punitive damage element, Florida’s judicial environment has been hard on businesses for years.3 Broward County and Miami-Dade County are known to issue nuclear verdicts most often. Between January 2016 and July 2023, there were 20 nuclear verdicts with $561.7 million in total awards.(1)
In 2023, Florida started to take steps to reduce the severe risk on businesses including a reduction on the statute of limitations and more regulations on the evidence admissible to prove the amount of a plaintiff’s damages for past or future medical care.
Being cognizant of the high-risk states is just one factor to consider during a healthcare M&A. For more information about risk and the current M&A healthcare landscape, read Executing a Successful Acquisition: Your Guide to Navigating Risk in Healthcare M&A
https://symphonyrisk.wpengine.com/wp-content/uploads/Symphony_RiskSolutions-Brochure-v6-sglpgs.pdf.
(1) Healthcare Liability Market Update, Source: Various internet articles with publication dates between September 1, 2016 and November 3, 2023. Accessed July 13, 2023.
(2) American Tort Reform Association “Nuclear Verdicts Explode in No. 1 Judicial Hellhole Georgia,” December 6, 2022.
(3) U.S. Chamber of Commerce Institute for Legal Reform “Nuclear Verdicts: Trends, Causes, and Solutions,” September 2022.
(4) JD Supra “Illinois Biometric Privacy Law Developments May Increase Risk to Businesses Generally But Protect Healthcare Employers from Suits,” February 21, 2023.
(5) State of California “Governor Newsom Signs Legislation to Modernize California’s Medical Malpractice System,” May 23, 2023.
(6) WalletHub “Best & Worst States for Doctors,” March 20, 2023.
(7) New York Civil Justice Institute “New York’s Nuisance Nuclear Verdicts,” May 4, 2022.