Guide · Updated
When medical care goes wrong
A bad result is not always someone’s fault. But sometimes care falls short and causes real harm. These claims have more steps than most injury claims, and the deadlines can be short. This guide explains the usual shape of a claim and links to your state’s rules.
Right away
Step 1: Get care, then keep a record
- Get the care you need nowYour health comes first. You can see a different doctor if you no longer trust the one who treated you. Tell the new doctor what happened.
- Write down what happenedNote the dates, the names of the people who treated you, what they told you and what you noticed. Do it while you still remember. Keep adding to it.
- Ask for your medical recordsYou have a right to a copy of your records from most doctors and hospitals. They must usually act on your request within 30 days, and they may take one 30-day extension if they tell you why in writing1. How to get your medical records explains how to ask.
- Keep everythingBills, letters, discharge papers, pill bottles and any device that was taken out of you or failed. Don’t throw them away or send them back.
Good to know
Step 2: What a malpractice claim is about
Medicine has risks, and some bad results happen even with good care. A claim usually turns on two questions. Did the care fall below what a careful provider would have done? And did that cause the harm?
These questions usually need a doctor’s opinion. That is one reason these claims take more work, and more time, than many other injury claims.
Good to know
Step 3: Extra steps before or soon after you file
Many states add steps for medical claims that other injury claims don’t have. The steps differ by state. Here are kinds you may see:
- A notice before you sueSome states require written notice to each doctor or hospital before a lawsuit is filed. In Texas, for example, the notice goes by certified mail with a signed form that lets them get your health records2. Michigan, Florida and West Virginia also require notice first.
- An expert’s opinionMany states want a qualified expert to back the claim, in writing, before or soon after filing. Florida, New Jersey, North Carolina, Texas and West Virginia each have a rule like this.
- Ways to pause the clockIn some states, a notice or a request for mediation gives you more time to sue. Mediation is a meeting with a neutral person to try to settle. See Ohio, Washington and Texas.
A missed step can end the claim
These steps are strict. In Texas, for example, if the expert report isn’t served in time and the doctor or hospital asks, the court must dismiss the claim for good. It must also award them reasonable lawyer’s fees and court costs3.
This week
Step 4: Deadlines are often different, and strict
Many states set a separate deadline for medical claims. Some count from the mistake. Some count from when you found out, or should have. Many also set an outer limit that can pass before you ever learn of the harm. Special rules often apply to children, to things left in the body, and to harm that was hidden.
Don’t guess at your deadline. Find your state’s deadlines, and read your state’s guide below if there is one. Because the extra steps take months, it helps to start early.
Good to know
Step 5: Limits on what you can get
Some states limit how much money you can get in a medical claim, often for pain and suffering.
When you’re ready
Step 6: What a lawyer does in these cases
You don’t have to hire one. Many people do for medical claims because of the extra steps. A lawyer usually gets your records, has a doctor review the care, and handles the notices and expert papers on time. See what a personal injury lawyer does.
If you talk to firms, bring your notes, your records and your bills. Ask how often they handle medical claims and who pays for the expert review. See how to choose a personal injury lawyer and how contingency fees work.
Next
Step 7: Your state’s rules
These state guides each have a section on medical claims, with the law cited: Arizona, Florida, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Dakota, Texas, Utah, Vermont, Virginia, Washington, West Virginia and Wyoming.
For any other state, start with your state’s deadlines.
Medical malpractice rules in your state
The deadline to file and the other rules for a medical malpractice case are set by each state. Pick yours.
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
When you’re ready
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Where the legal facts on this page come from
- 45 C.F.R. § 164.524 (access of individuals to protected health information)“(a)(1) … an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a designated record set … (b) … (1) … The covered entity may require individuals to make requests for access in writing, provided that it informs individuals of such a requirement. (2) Timely action by the covered entity. (i) Except as provided in paragraph (b)(2)(ii) of this section, the covered entity must act on a request for access no later than 30 days after receipt of the request … (ii) If the covered entity is unable to take an action … within the time required … the covered entity may extend the time for such actions by no more than 30 days, provided that: (A) The covered entity, within the time limit set by paragraph (b)(2)(i) of this section, as applicable, provides the individual with a written statement of the reasons for the delay and the date by which the covered entity will complete its action on the request; and (B) The covered entity may have only one such extension of time for action on a request for access. (c) … (2) … (ii) … if the protected health information that is the subject of a request for access is maintained in one or more designated record sets electronically and if the individual requests an electronic copy of such information, the covered entity must provide the individual with access to the protected health information in the electronic form and format requested by the individual, if it is readily producible in such form and format; or, if not, in a readable electronic form and format as agreed to by the covered entity and the individual. (3) … (ii) If an individual's request for access directs the covered entity to transmit the copy of protected health information directly to another person designated by the individual, the covered entity must provide the copy to the person designated by the individual. The individual's request must be in writing, signed by the individual, and clearly identify the designated person and where to send the copy of protected health information. (4) Fees. If the individual requests a copy of the protected health information or agrees to a summary or explanation of such information, the covered entity may impose a reasonable, cost-based fee, provided that the fee includes only the cost of: (i) Labor for copying … (ii) Supplies for creating the paper copy or electronic media if the individual requests that the electronic copy be provided on portable media; (iii) Postage … and (iv) Preparing an explanation or summary … (d) … (1) Making other information accessible. The covered entity must, to the extent possible, give the individual access to any other protected health information requested, after excluding the protected health information as to which the covered entity has a ground to deny access. (2) Denial. The covered entity must provide a timely, written denial to the individual … The denial must be in plain language and contain: (i) The basis for the denial; … (iii) A description of how the individual may complain to the covered entity … or to the Secretary pursuant to the procedures in § 160.306.”Read the source: 45 C.F.R. § 164.524 (access of individuals to protected health information)
- Tex. Civ. Prac. & Rem. Code § 74.051 (notice)“(a) Any person or his authorized agent asserting a health care liability claim shall give written notice of such claim by certified mail, return receipt requested, to each physician or health care provider against whom such claim is being made at least 60 days before the filing of a suit in any court of this state based upon a health care liability claim. The notice must be accompanied by the authorization form for release of protected health information as required under Section 74.052. … (c) Notice given as provided in this chapter shall toll the applicable statute of limitations to and including a period of 75 days following the giving of the notice, and this tolling shall apply to all parties and potential parties.”Read the source: Tex. Civ. Prac. & Rem. Code § 74.051 (notice)
- Tex. Civ. Prac. & Rem. Code § 74.351 (expert report)“(a) In a health care liability claim, a claimant shall, not later than the 120th day after the date each defendant's original answer is filed or a later date required under Section 74.353, serve on that party or the party's attorney one or more expert reports, with a curriculum vitae of each expert listed in the report for each physician or health care provider against whom a liability claim is asserted. The date for serving the report may be extended by written agreement of the affected parties. … (b) If, as to a defendant physician or health care provider, an expert report has not been served within the period specified by Subsection (a), the court, on the motion of the affected physician or health care provider, shall, subject to Subsection (c), enter an order that: (1) awards to the affected physician or health care provider reasonable attorney's fees and costs of court … and (2) dismisses the claim with respect to the physician or health care provider, with prejudice to the refiling of the claim. (c) … the court may grant one 30-day extension to the claimant in order to cure the deficiency.”Read the source: Tex. Civ. Prac. & Rem. Code § 74.351 (expert report)
This is general information, not legal advice.