Massachusetts Medical Malpractice Lawyer

How medical malpractice cases proceed under Massachusetts law

A Massachusetts medical malpractice claim is not a claim about a bad outcome; it is a claim about a broken standard. M.G.L. c. 231, sec. 60B frames the dividing line directly, asking whether the evidence raises a legitimate question of liability appropriate for judicial inquiry or whether the case is merely an unfortunate medical result. A Massachusetts claim has to show four things: that a provider owed the patient a duty, that the provider breached the applicable standard of care, that the breach caused the injury, and that the injury produced damages. Massachusetts measures that standard by what the average qualified practitioner in the relevant field would have done, a rule the Supreme Judicial Court adopted in Brune v. Belinkoff, 354 Mass. 102 (1968), replacing the older practice of judging a doctor by the customs of the doctor's own community. Because it is not a local standard, an expert reviewing a the Commonwealth case does not have to practice nearby. A separate and independent route to liability exists where a provider failed to obtain informed consent, addressed in Harnish v. Children's Hospital Medical Center, 387 Mass. 152 (1982).

Before a Massachusetts claim reaches a courtroom, Massachusetts requires two procedural steps most other tort claims never face. M.G.L. c. 231, sec. 60L requires 182 days of written notice to the provider, stating six specific things: the factual basis for the claim, the applicable standard of care, how it was breached, what should have been done instead, how the breach proximately caused the injury, and the names of every provider being notified. Once suit is filed, every action for malpractice, error or mistake against a provider of health care is screened by a tribunal under sec. 60B, a panel of a Superior Court justice, a physician and an attorney, held within fifteen days after the defendant's answer is filed. The tribunal decides whether the plaintiff's offer of proof clears that liability threshold. If the finding goes against the the Commonwealth plaintiff, the case can still proceed, but only after posting a six-thousand-dollar bond within thirty days, or the action is dismissed.

Massachusetts caps part of what a Massachusetts malpractice claim can recover, and the caps are narrower than they first sound. M.G.L. c. 231, sec. 60H limits pain and suffering, loss of companionship and other general damages to five hundred thousand dollars, unless there is a substantial or permanent loss of a bodily function, substantial disfigurement, or other special circumstances; medical expenses, future care and lost earning capacity are not capped by that section. A separate cap under sec. 85K limits recovery against a charitable health care organization to one hundred thousand dollars. The filing clock runs under M.G.L. c. 260, sec. 4: three years from accrual, with an outer limit of seven years from the act or omission, except where the claim involves a foreign object left in the body. Massachusetts also recognizes loss of chance as its own compensable injury. In Matsuyama v. Birnbaum, 452 Mass. 1 (2008), the Supreme Judicial Court held that a the Commonwealth patient whose odds of survival were already below fifty percent before the negligence can still recover, with damages scaled to the size of the chance destroyed rather than paid in full or refused outright.

Massachusetts statutes and case law

• M.G.L. c. 231, sec. 60B. Requires every malpractice, error or mistake action against a provider of health care to be screened first by a tribunal (a Superior Court justice, a physician and an attorney), which decides whether the offer of proof raises a legitimate question of liability or is merely an unfortunate medical result; an adverse finding requires a six-thousand-dollar bond within thirty days to continue.
• M.G.L. c. 231, sec. 60L. Requires 182 days of written notice to the provider before suit, stating the factual basis, the standard of care, the breach, the proper course, causation, and the names of every provider notified; the period can shorten to 90 days in specified circumstances.
• M.G.L. c. 231, sec. 60H. Caps pain and suffering, loss of companionship and other general damages at five hundred thousand dollars, unless there is a substantial or permanent loss of a bodily function, substantial disfigurement, or other special circumstances; economic damages are not capped.
• M.G.L. c. 231, sec. 85K. Limits recovery in a medical malpractice claim against a charitable organization providing health care to one hundred thousand dollars, exclusive of interest and costs.
• M.G.L. c. 260, sec. 4. Sets the filing deadline at three years after the claim accrues, with an outer limit of seven years after the act or omission, except where the claim is based on a foreign object left in the body.
• M.G.L. c. 231, sec. 60D. Gives a child injured before age six until their ninth birthday to bring a malpractice claim; older minors follow the ordinary three-year rule, and the seven-year repose in c. 260, sec. 4 still applies to a minor's claim.
• M.G.L. c. 229, sec. 2. Governs a wrongful death claim where malpractice causes death; the action must be commenced within three years of the date of death, or within three years of when the estate's executor or administrator knew or reasonably should have known of the claim.

Common case patterns

1. A Massachusetts patient whose cancer or other serious condition was diagnosed late, evaluated under the loss of chance doctrine because the delay may have destroyed a chance of survival that was already under fifty percent.
2. A the Commonwealth surgical or treatment decision that fell below what the average qualified practitioner in the field would have done, causing a new and separate injury.
3. A Massachusetts patient who signed a consent form but was never told about a material risk that later occurred, raising an informed-consent claim independent of any technical error.
4. A Massachusetts child injured at birth or in early treatment, where the minor's deadline in sec. 60D and the seven-year repose in c. 260, sec. 4 both have to be tracked.
5. A claim against a charitable the Commonwealth hospital, where the amount recoverable is affected by the nonprofit damages cap in sec. 85K.

Typical timeline

1. Before anything is filed, a Massachusetts claim needs its records reviewed and an expert opinion obtained, because the notice required by sec. 60L has to state the standard of care, the breach and the causal link before the provider ever sees a complaint. That 182-day notice period runs first, and it can shorten to 90 days where notice has already gone to another provider on the same claim.
2. Once suit is filed, a the Commonwealth claim is screened by the tribunal under sec. 60B within fifteen days of the defendant's answer. An adverse finding does not end the case, but it requires posting a six-thousand-dollar bond within thirty days to continue through the ordinary judicial process.
3. Litigation or settlement proceeds from there, governed by the deadlines in c. 260, sec. 4 (three years from accrual, seven years outer limit) and the damages framework in sec. 60H and sec. 85K. A Massachusetts claim involving death converts to a wrongful death action under M.G.L. c. 229, sec. 2, with its own three-year clock measured from the date of death or from when the estate's representative discovered the claim.

What can be recovered

• Medical expenses, past and future, not subject to the general-damages cap.
• Lost earning capacity, also uncapped as an economic loss.
• Pain and suffering, loss of companionship and other general damages, capped at five hundred thousand dollars unless a statutory exception applies under sec. 60H.
• Loss-of-chance damages, sized to the chance a delay or error destroyed rather than to the full value of a better outcome, under Matsuyama v. Birnbaum.
• A capped recovery, not exceeding one hundred thousand dollars, where the claim is against a charitable health care organization under sec. 85K.
• Wrongful-death damages under M.G.L. c. 229, sec. 2 where the malpractice caused death, brought by the estate's executor or administrator.

Key terms

Standard of care

The level of skill and care a reasonably competent provider in the same field would have used under similar circumstances.

Medical malpractice tribunal

The screening panel under M.G.L. c. 231 sec. 60B that every malpractice claim must pass before it proceeds on the merits.

Seven-year repose

The outer limit on when a Massachusetts medical malpractice claim can be filed, beyond the ordinary three-year deadline.

Discovery rule

The rule that can start the filing clock when the injury was reasonably discovered rather than when it occurred.

Ordinary personal-injury claim vs. medical malpractice claim

More questions

• What is considered medical malpractice in Massachusetts?

  Care that fell below the standard a reasonably competent practitioner in the same field would have met, where that failure caused the patient harm. All four elements have to be present: duty, breach of the standard of care, causation and damages. M.G.L. c. 231, sec. 60B frames the screening question as whether the evidence raises a legitimate question of liability appropriate for judicial inquiry, or is merely an unfortunate medical result.

• Is a bad surgical outcome in Massachusetts automatically malpractice?

  No. Known complications occur without anyone doing anything wrong, and some conditions have poor outcomes under any competent treatment. What makes an outcome actionable is evidence that a specific decision or omission fell below the standard set in Brune v. Belinkoff, 354 Mass. 102 (1968), the average qualified practitioner standard, and that the outcome would have been different without it.

• What is the medical malpractice tribunal, and what happens if I lose there?

  Under M.G.L. c. 231, sec. 60B, every malpractice action against a provider of health care is heard first by a tribunal of a Superior Court justice, a physician and an attorney, which decides whether the offer of proof raises a legitimate question of liability. A finding against the plaintiff does not end the case, but continuing requires posting a six-thousand-dollar bond within thirty days.

• Can I still have a claim if my chance of survival was already less than fifty percent?

  Often yes. In Matsuyama v. Birnbaum, 452 Mass. 1 (2008), the Supreme Judicial Court held that loss of chance is its own compensable injury, so a patient whose odds were already below fifty percent before the negligence still has a claim; the fact that the outcome was more likely than not to happen anyway affects the size of the award rather than ending the case.

• How long do I have to bring a Massachusetts medical malpractice claim?

  Generally three years from when the claim accrues, under M.G.L. c. 260, sec. 4, with an outer limit of seven years from the act or omission except for a foreign object left in the body. Because the 182-day notice required by sec. 60L has to be sent before suit is filed, the practical deadline for starting the process is earlier than the three-year date.