Medical Malpractice Law by State
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Medical malpractice is governed almost entirely by state law. While the core framework — the four-element negligence test — is consistent nationally, the procedural and substantive details vary dramatically from state to state. Filing a malpractice claim in the wrong state, missing a state-specific pre-suit deadline, or failing to file a required expert affidavit can permanently destroy an otherwise viable claim.
Understanding the specific rules that apply in the state where the malpractice occurred is not optional — it is the foundation of any viable claim strategy.
The Most Important State-Specific Rules
Statute of Limitations
Ranges from 1 year (Kentucky, Tennessee, Ohio) to 3 years (Washington, North Carolina, California) from the date of malpractice or discovery. Outside deadlines (statutes of repose) of 3–10 years apply in many states. See the full table: statute of limitations by state →
Damage Caps
Approximately 30 states cap non-economic or total damages. Caps range from $250,000 (Texas, per defendant) to over $1,000,000 in some states. Multiple states' caps have been struck down as unconstitutional. See the full table: damage caps by state →
Pre-Suit Requirements
Most states require a certificate of merit or affidavit from a medical expert before or immediately after filing. Some states — including Florida (90 days), Michigan (182 days), and Tennessee (60 days) — require pre-suit notice and a waiting period. Indiana and Louisiana require review by a medical panel before suit can be filed.
Expert Qualification Rules
Most states require the plaintiff's standard-of-care expert to be board certified in the same specialty as the defendant. Requirements vary — some states are more flexible about related specialties; others require active clinical practice within a specified recent period.