Massachusetts handles medical malpractice lawsuits differently from most other injury cases. Before a malpractice case can move forward in the usual way, it goes through an early screening step called the medical malpractice tribunal. Patients are often surprised to learn about it, and about the bond that can be required if the tribunal’s finding goes against them.
Here is a plain-English look at how the tribunal works, what it decides, and what happens afterward. If you are still early in the process, start with our companion article on medical malpractice deadlines in Massachusetts.
What Is the Medical Malpractice Tribunal?
The tribunal is a screening panel created by Massachusetts General Laws chapter 231, section 60B. Its job is to separate claims that raise a real question about a provider’s liability from cases that reflect what the statute calls an “unfortunate medical result,” meaning a bad outcome that does not by itself show negligence.
The tribunal does not decide who wins the case. It only decides whether the case can proceed without additional conditions.
Who sits on the tribunal
Under the statute, the panel has three members:
- A Superior Court justice
- A physician licensed in Massachusetts, chosen from a list provided by the Massachusetts Medical Society (when the defendant is not a physician, a representative of the relevant health care field takes this seat)
- An attorney licensed in Massachusetts, chosen from a list provided by the Massachusetts Bar Association
The statute requires the physician member to practice outside the county where the defendant practices or resides, or where the facility is located.
When the Tribunal Happens
The tribunal hearing comes after the lawsuit is filed. The statute calls for the hearing within fifteen days after the defendant files its answer, although in practice scheduling can vary.
Remember that a lawsuit usually cannot be filed until the pre-suit notice period under chapter 231, section 60L has run, so the tribunal is typically several months into the overall process.
What the Tribunal Looks At
The patient (the plaintiff) presents an “offer of proof.” This is not a full trial with live witnesses. It is a written presentation of the evidence the plaintiff expects to prove, which commonly includes:
- The relevant medical records
- A written opinion from a qualified medical professional explaining the standard of care, how it was breached and how that caused the injury
- Other supporting documents, such as imaging, test results or deposition excerpts if available
The tribunal asks whether the evidence, if properly substantiated, is sufficient to raise a legitimate question of liability appropriate for judicial inquiry. The bar is meant to screen out claims without adequate support, not to weigh which side’s experts are more convincing.
Because the expert opinion is so central, preparing it carefully is one of the most important steps in the case.
What Happens After the Finding
If the finding favors the patient
The case moves forward through ordinary litigation: discovery, depositions, expert disclosures, possible mediation and, if it does not resolve, trial.
If the finding favors the provider
The case is not automatically over. Under section 60B, the patient may still pursue the claim, but only after posting a bond of $6,000 with the court clerk within thirty days of the finding. The bond is available to cover certain costs and fees, including the defendant’s attorney’s fees, if the patient ultimately does not prevail. Key points:
- The judge has discretion to increase the bond amount.
- For a patient who is indigent, the judge may reduce the bond on motion, but the statute does not allow it to be eliminated.
- If the bond is not posted within thirty days, the case is dismissed.
A finding for the provider is an important signal, and it is a good moment to reassess the strength of the case with your lawyer.
A Related Rule: The Cap on Non-Economic Damages
Massachusetts also limits certain damages in malpractice cases. Under chapter 231, section 60H, awards for general damages such as pain and suffering, loss of companionship and embarrassment are generally capped at $500,000.
The statute lists exceptions. The cap does not apply if the jury or judge finds:
- Substantial or permanent loss or impairment of a bodily function
- Substantial disfigurement
- Other special circumstances that would make the cap deny just compensation
The cap applies to general (non-economic) damages. It does not apply to economic losses such as medical bills and lost wages. For catastrophic harm, see our page on catastrophic and traumatic brain injury claims.
Frequently Asked Questions
Do I have to testify at the tribunal?
Generally, no. The tribunal reviews a written offer of proof rather than holding a full evidentiary hearing with live testimony. Your lawyer handles the presentation.
Does the tribunal decide how much my case is worth?
No. The tribunal only screens whether the claim raises a legitimate question of liability. It does not decide fault or damages; those questions are resolved later through settlement or trial.
What if the tribunal rules against me and I cannot afford the bond?
The statute allows the judge, on motion, to reduce the $6,000 bond for an indigent patient, but not to waive it entirely. The bond must be posted within thirty days of the finding, so this issue needs prompt attention.
Get Guidance Before You File
Malpractice cases require careful preparation from the start, from the 182-day notice through the tribunal and beyond. To learn more about our approach, see our medical malpractice page or read what to expect when you contact us. Call Muggeo & Associates at 978-741-1177 or contact us online.
This article provides general information only and is not legal advice. Laws change and outcomes depend on the facts of each case.