American Journal of Law & Medicine, 34 (2008): 489-533 © 2008 American Society of Law, Medicine & Ethics Boston University School of Law Adjudicating Severe Birth Injury Claims in Florida and Virginia: The Experience of a Landmark Experiment in Personal Injury Compensation Gil Siegal, † Michelle M. Mello †† and David M. Studdert ††† I. INTRODUCTION Policy debates over medical malpractice in the United States involve a complex amalgam of legal doctrine, public demands to address the problem of medical errors, and the interests of various stakeholder groups. 1 Most parties can agree, however, that the current system for compensating medical injury performs poorly. It falls short of achieving its two main goals: compensation and deterrence. The current system of tort liability is “neither sensitive nor specific in its distribution of compensation:” 2 the vast majority of patients injured by negligent medical care do not receive compensation, yet the system compensates some cases that do not appear to involve negligence. 3 † Gil Siegal is Director of the Center for Health Law and Bioethics, Ono Academic College, Israel and Professor, University of Virginia School of Law. †† Michelle M. Mello is Professor of Law and Public Health, Department of Health Policy and Management, Harvard School of Public Health. ††† David M. Studdert is Professor and Federation Fellow, Faculty of Law and Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne. This work was funded by a grant from The Robert Wood Johnson Foundation. The authors thank Patricia Moran for excellent research assistance and Tifani Jones and Elizabeth Abernathey for editorial assistance. 1 See, for example, the debate over defensive medicine described in Office of Technology Assessment, U.S. Congress, Defensive Medicine and Medical Malpractice 1-3 (1994). 2 Daniel P. Kessler, The Effect of the U.S. Malpractice System: A Review of the Medical Literature 2 (2007) (Unpublished manuscript, available at http://www.pointoflaw.com/pdfs/kessler-malpractice-jced1.pdf). 3 A. Russell Localio et al., Relation Between Malpractice Claims and Adverse Events Due to Negligence: Results of the Harvard Medical Practice Study III, 325 New Eng. J. Med. 245, 247-49 (1991); David M. Studdert et al., Claims, Errors, and Compensation Payments in Medical Malpractice Litigation, 354 New Eng. J. Med. 2024, 2025, 2028 (2006); David M. Studdert et al., Negligent Care and Malpractice Claiming Behavior in Utah and Colorado, 38 Med. Care 250, 256 (2000).