Despite years of training and experience, even the best medical professionals make mistakes. Some medical mistakes are minor, but others can lead to grave consequences, including permanent injury and death.
When these errors occur due to negligence or malpractice, a medical malpractice lawsuit may be filed by the victim or their family. The goal of these lawsuits is to recover compensation for the damages incurred, such as medical bills, rehabilitation or treatment costs, lost income, and, in the most tragic cases, funeral costs.
The National Practitioner Data Bank (NPDB) contains data going back to 1990 on medical malpractice payouts, which result from lawsuits that ended in a settlement or a judgment. If the doctor won or the case was dismissed, it didn’t result in a payout and therefore isn’t included in the data.
In partnership with 1Point21 Interactive, Gill Ports Hoste analyzed data from the last 10 years (2015-2025) to better understand medical malpractice payout trends in the United States.
This study dives into the most common medical errors that lead to payouts, which errors result in the highest payouts, and how these figures differ by injury severity, practitioner, and location.
Quick Facts
In this report
- Types of Medical Errors
- Most Common Errors
- Highest Average Payouts by Error
- Top 5 Highest Total Payouts
- Injury Severity
- Type of Practitioner
- State Analysis
- Trends & Demographics
Types of Medical Malpractice Errors That Lead to Payouts
The data categorizes specific medical errors into broader types. The bubble chart below shows the proportion of which error types lead to the most medical malpractice payouts, and the table shows how many of these payouts exceed $1 million.
Treatment, diagnostic, and surgery-related cases top the charts. Following those three, there is a big gap before the next category. Obstetrics-related allegations, which ranked fourth in volume, represent a share about four times lower than surgery-related errors.
Table: Medical Malpractice Error Types by PAYOUT Count
| Type of Error | Payout Count | Payouts Over $1M | % of Payouts Over $1M |
| Treatment Related | 35,560 | 17,662 | 49.67% |
| Diagnosis Related | 32,725 | 2,293 | 7.01% |
| Surgery Related | 29,639 | 1,361 | 4.59% |
| Obstetrics Related | 6,933 | 908 | 13.10% |
| Medication Related | 6,227 | 267 | 4.29% |
| Monitoring Related | 4,639 | 209 | 4.51% |
| Behavioral Health Related | 3,538 | 81 | 2.29% |
| Anesthesia Related | 3,174 | 225 | 7.09% |
| Equipment/Product Related | 856 | 18 | 2.10% |
| Other or Miscellaneous | 797 | 13 | 1.63% |
| IV and Blood Products Related | 229 | 14 | 6.11% |
25 Most Common Errors That Lead to Medical Malpractice Payouts
In addition to the type of error, each payout references a specific allegation that led to the medical malpractice lawsuit being filed. There are 84 specific allegations in the data, but below we show just the top 25.
The two most common errors by a wide margin are Inappropriate Procedure/Treatment and Failure to Diagnose.
Examples of common Failure to Diagnose cases include strokes and cancer, where a doctor fails to recognize the patient’s symptoms in time to avoid serious harm.
| Rank | Specific Allegation | Payouts | Payouts Over $1M | % of Payouts Over $1M |
| 1 | Inappropriate Procedure/Treatment | 25,696 | 959 | 3.73% |
| 2 | Failure to Diagnose | 21,543 | 1,483 | 6.88% |
| 3 | Performance of Wrong Procedure | 8,575 | 482 | 5.62% |
| 4 | Failure to Treat | 8,186 | 286 | 3.49% |
| 5 | Delay in Diagnosis | 7,936 | 584 | 7.36% |
| 6 | Failure to Recognize a Complication | 4,604 | 303 | 6.58% |
| 7 | Failure to Monitor | 4,371 | 223 | 5.10% |
| 8 | Surgery on Wrong Body Part/Patient | 4,360 | 154 | 3.53% |
| 9 | Delay in Referral/Consultation | 3,306 | 207 | 6.26% |
| 10 | Failure to Order Appropriate Test | 2,039 | 150 | 7.36% |
| 11 | Failure to Perform Procedure | 2,029 | 116 | 5.72% |
| 12 | Lack of/Failure to Obtain Informed Consent | 1,661 | 19 | 1.14% |
| 13 | Premature/Inappropriate Discharge | 1,557 | 91 | 5.84% |
| 14 | Failure to Order Appropriate Medication | 1,329 | 68 | 5.12% |
| 15 | Delay in Performance of Surgery/Procedure | 1,181 | 111 | 9.40% |
| 16 | Failure to Identify Fetal Distress | 1,097 | 222 | 20.24% |
| 17 | Wrong Dosage | 1,097 | 41 | 3.74% |
| 18 | Suicide/Attempted Suicide of Patient | 1,082 | 12 | 1.11% |
| 19 | Improper Handling/Management of Surgical Specimen | 1,030 | 92 | 8.93% |
| 20 | Delay in Treatment | 879 | 96 | 10.92% |
| 21 | Fall | 878 | 26 | 2.96% |
| 22 | Delivery Related | 811 | 36 | 4.44% |
| 23 | Failure to Medicate | 747 | 33 | 4.42% |
| 24 | Obstetrics, Not Otherwise Classified | 718 | 28 | 3.90% |
| 25 | Inadequate Monitoring During Procedure | 657 | 22 | 3.35% |
Highest Average Payouts by Medical Error
Taking a look at the financial data, we can see which specific errors lead to the highest average payouts. Included in the table is the maximum payout that allegation received.
Failure to Identify Fetal Distress ranked number 16 on the table above, yet these cases had the highest average payouts. Failure to Treat Fetal Distress comes in second, underscoring just how catastrophic fetal distress errors can be.
One important note is that the NPDB reports payouts in ranges, so the numbers are not exact. NPDB uses the midpoint of the range; for example, a reported payout of $27,500,000 represents an actual payment somewhere between $25,000,001 and $30,000,000.
| Medical Error | Average Payout | Payout Count | Highest Payout |
| Failure to Identify Fetal Distress | $1,152,871 | 1,097 | $27,500,000 |
| Failure to Treat Fetal Distress | $1,026,242 | 391 | $27,500,000 |
| Improper Technique | $870,893 | 91 | $6,750,000 |
| Equipment Unavailable | $770,208 | 18 | $3,950,000 |
| Delay in Treatment | $762,096 | 879 | $22,500,000 |
| Failure to Perform Resuscitation | $755,656 | 101 | $6,450,000 |
| Improper/Inappropriate Medication | $627,470 | 126 | $2,950,000 |
| Delay in Performance of Surgery/Procedure | $608,471 | 1,181 | $22,500,000 |
| Foreign Body Left During Procedure | $604,159 | 223 | $9,450,000 |
| Improper Management of Pregnancy/Delivery | $578,636 | 391 | $13,500,000 |
| Post-Operative Complications | $565,927 | 593 | $5,450,000 |
| Failure to Delay a Case When Indicated | $563,209 | 183 | $14,500,000 |
| Failure to Order Appropriate Test | $510,309 | 2,039 | $55,000,000 |
| Prenatal Related | $504,375 | 327 | $12,500,000 |
| Improper/Inappropriate Anesthesia Management | $500,786 | 480 | $10,500,000 |
| Improper/Inappropriate Intubation | $472,783 | 113 | $6,650,000 |
| Failure to Diagnose | $471,318 | 21,543 | $27,500,000 |
| Delay in Diagnosis | $469,874 | 7,936 | $18,500,000 |
| Failure to Act on Monitoring Findings | $463,958 | 24 | $1,250,000 |
| Improper Handling/Management of Surgical Specimen | $463,404 | 1,030 | $5,950,000 |
When we look instead at the highest total payouts instead of the highest average payouts, we see the following:
Top 5 Highest Medical Malpractice Payouts
Payouts by Injury Severity
The NPDB data includes the severity of the injury associated with each malpractice claim. The table below is sorted by which injuries lead to the most payouts. Surprisingly, minor temporary injuries come in second; however, only 0.55% of those payouts were over $1 million.
When looking at the injuries by average payout, grave permanent injuries top the list, even above death.
| Injury Severity | Payout Count | Payouts Over $1M | % of Payouts Over $1M | Average Payout |
| Death | 34,368 | 1,975 | 5.75% | $431,618 |
| Minor Temporary Injury | 18,788 | 103 | 0.55% | $102,649 |
| Significant Permanent Injury | 17,045 | 1,229 | 7.21% | $512,873 |
| Minor Permanent Injury | 14,538 | 363 | 2.50% | $252,430 |
| Major Temporary Injury | 14,180 | 328 | 2.31% | $255,751 |
| Major Permanent Injury | 12,750 | 1,504 | 11.80% | $691,193 |
| Grave Permanent Injury | 5,336 | 1,052 | 19.72% | $1,077,726 |
| Insignificant Injury | 3,037 | 5 | 0.16% | $41,043 |
| Emotional Injury Only | 2,661 | 25 | 0.94% | $151,637 |
| Cannot Be Determined | 1,614 | 29 | 1.80% | $163,940 |
Top 20 Practitioners Involved in Medical Malpractice Payouts
The table below is ranked by which practitioner types are associated with the most payouts.
Physicians come in first for total payouts; however, nurse midwives have the highest average payout with $860,497. They also have the highest percentage of payouts that are over $1 million (11%).
| Rank | Type of Practitioner | Payout Count | Payouts Over $1M | % of Payouts Over $1M | Average Payout |
| 1 | Physician (MD) | 82,471 | 5,389 | 6.53% | $444,666 |
| 2 | Dentist | 13,550 | 107 | 0.79% | $108,734 |
| 3 | Osteopathic Physician (DO) | 8,143 | 393 | 4.83% | $439,156 |
| 4 | Registered Nurse | 3,713 | 275 | 7.41% | $410,527 |
| 5 | Nurse Practitioner | 3,136 | 107 | 3.41% | $361,411 |
| 6 | Physician Assistant | 2,557 | 97 | 3.79% | $360,771 |
| 7 | Podiatrist | 2,450 | 28 | 1.14% | $256,112 |
| 8 | Chiropractor | 1,747 | 12 | 0.69% | $171,144 |
| 9 | Nurse Anesthetist | 844 | 24 | 2.84% | $381,849 |
| 10 | Physical Therapist | 658 | 1 | 0.15% | $122,281 |
| 11 | Nurse Midwife | 582 | 64 | 11% | $860,497 |
| 12 | Pharmacist | 542 | 14 | 2.58% | $144,465 |
| 13 | Licensed Practical or Vocational Nurse | 415 | 13 | 3.13% | $317,854 |
| 14 | Massage Therapist | 415 | 1 | 0.24% | $42,964 |
| 15 | Optometrist | 392 | 17 | 4.34% | $324,942 |
| 16 | Physician Resident (MD) | 366 | 33 | 9.02% | $518,906 |
| 17 | Acupuncturist | 281 | 0 | 0% | $52,484 |
| 18 | Psychologist | 240 | 1 | 0.42% | $190,354 |
| 19 | Social Worker | 167 | 3 | 1.80% | $186,495 |
| 20 | Other Health Care Practitioner – Not Classified | 160 | 3 | 1.88% | $193,733 |
Which States Have the Most (and Highest Average) Payouts?
Naturally, some states have higher claim volumes and bigger payouts than others. This reflects a variety of factors, including the population size, number of practitioners, state laws, and damage caps.
Top 10 States by Number of Payouts
The table below shows which states have the highest number of medical malpractice payouts relative to their population size. Census data from 2024 was used to calculate the rate of cases per 100,000 residents. These ten states have a higher rate of residents who were involved in a medical malpractice payout.
California and Texas, for example, are in the top five states for total number of payouts, but when taking into account the population of those states, they don’t make the cut. New York has both the highest number of payouts and the highest rate of payouts.
| Rank | State | Payout Count | Payouts per 100K Residents |
| 1 | New York | 11,076 | 56.6 |
| 2 | Pennsylvania | 6,958 | 53.7 |
| 3 | New Mexico | 1,012 | 47.9 |
| 4 | Louisiana | 2,187 | 47.8 |
| 5 | West Virginia | 801 | 45.3 |
| 6 | New Jersey | 3,781 | 40.7 |
| 7 | Florida | 9,011 | 39.9 |
| 8 | Oklahoma | 1,252 | 30.9 |
| 9 | Indiana | 2,075 | 30.2 |
| 10 | Kansas | 852 | 29 |
Top 10 States by Highest Average Payout
Many of the states in the table below don’t cap damages in medical malpractice cases, which is why they have high payouts. Some states with large populations, like California and Texas, have strict caps on damages in these cases, so they didn’t make the top ten.
| Rank | State | Average Payout |
| 1 | Massachusetts | $732,963 |
| 2 | Illinois | $669,531 |
| 3 | Wyoming | $649,203 |
| 4 | Connecticut | $619,085 |
| 5 | Maine | $612,499 |
| 6 | South Dakota | $584,500 |
| 7 | New Hampshire | $584,179 |
| 8 | Minnesota | $581,868 |
| 9 | Alaska | $571,425 |
| 10 | Hawaii | $571,138 |
Trends & Demographics
Looking at total payouts over the 10-year period, we see the biggest dip in 2021. There could be a few factors contributing to this decline.
In general, there has been a downward trend in medical malpractice cases, noted by multiple researchers. This could be due to tort reform, higher barriers to filing, and fewer attorneys willing to take cases since the litigation costs are so high.
Then in 2020, the pandemic hit, continuing to push this trend downward. The increase that began after 2021 could be a backlog of cases that were postponed due to the pandemic, or perhaps the overall trends have reversed.
In terms of patient age, we see that payouts are most common among those aged 50-59, with cases rising steadily to that age group and then declining in patients aged 60 and up.
Final Thoughts
The data above paints a clear picture: medical malpractice payouts most often stem from treatment or diagnostic errors, and the most severe consequences, like grave permanent injuries, lead to the highest average payouts. Beyond that, the numbers vary depending on the type of practitioner, the state, and the patient.
What the data can’t tell us is why certain errors occur more frequently than others, and what, if anything, can be done to reduce these mistakes and the damage they cause.
If you or a loved one has been harmed by what you believe was negligence, our compassionate team of Chicago medical malpractice attorneys can help. Each case is unique, and only an experienced attorney like those at Gill Ports Hoste can help evaluate whether your situation warrants a claim.
For more information, reach out and schedule a free consultation.
Methodology
We conducted our analysis using the National Practitioner Data Bank’s public use data file, looking at data over a 10-year period (2015-2025).
Fair Use Statement
Findings from this report may be shared; we just ask that a link to this page be included so that readers may access the full study.