Key Takeaways

• Highest risk states: New Mexico leads the nation with 130.98 malpractice reports per 1,000 practitioners, 2.4 times the national average of 54.91. New York (108.99), Pennsylvania (100.80), Florida (96.86), and Hawaii (85.85) round out the top five.
• Regional divide: The Northeast carries the highest weighted malpractice rate at 87.75 per 1,000 practitioners, nearly double the Midwest’s 44.16. Eight of the top 10 states are located east of the Mississippi River.
• Lowest risk states: North Dakota has the lowest rate in the country at 14.04 per 1,000 practitioners. Minnesota (17.42), Wyoming (21.20), Alabama (24.51), and Wisconsin (24.83) complete the bottom five. 

Every year, thousands of medical practitioners across the United States are named in malpractice reports, a process that can reshape careers, alter hospital staffing decisions, and influence where physicians choose to practice. For patients, these reports represent cases where medical care fell short of expected standards, sometimes with life-changing consequences. For practitioners, they reflect a professional and legal landscape that varies dramatically depending on which state they are licensed in.

This study, conducted by Kitchel Law, analyzed publicly available records from the National Practitioner Data Bank (NPDB). Medical malpractice payment reports filed between 2021 and 2025 were collected for all 50 states. Total reports for each state were divided by the state’s total medical practitioner count over the same period, then multiplied by 1,000 to produce a standardized rate of malpractice reports per 1,000 practitioners. States were then ranked from highest (#1) to lowest (#50) based on this rate.

States With the Highest Medical Malpractice Rates

Table 1: Top 10 States by Malpractice Rate per 1,000 Practitioners (2021 to 2025)

Rank	State	Rate per 1,000	Total Reports	Practitioners
1	New Mexico	130.98	816	6,230
2	New York	108.99	5,932	54,429
3	Pennsylvania	100.80	3,922	38,908
4	Florida	96.86	5,875	60,654
5	Hawaii	85.85	196	2,283
6	New Jersey	83.76	2,768	33,046
7	Georgia	83.72	1,570	18,753
8	Indiana	76.87	1,277	16,613
9	South Carolina	73.62	778	10,568
10	Maryland	71.10	1,114	15,668

The top-ranked state, New Mexico, records a rate of 130.98 per 1,000 practitioners, approximately 22 points higher than the second-ranked state, New York, at 108.99.

States With the Lowest Medical Malpractice Rates

Table 2: Bottom 10 States by Malpractice Rate per 1,000 Practitioners (2021 to 2025)

Rank	State	Rate per 1,000	Total Reports
41	Vermont	26.55	79
42	Alaska	26.21	88
43	Maine	25.45	139
44	Arkansas	25.30	258
45	Colorado	24.92	550
46	Wisconsin	24.83	297
47	Alabama	24.51	452
48	Wyoming	21.20	53
49	Minnesota	17.42	228
50	North Dakota	14.04	38

The bottom 10 states collectively recorded just 2,182 total reports over five years, fewer than the third-ranked state, Pennsylvania, alone (3,922). 

States With the Most Total Malpractice Reports

Table 3: Top 10 States by Total Report Volume (2021 to 2025)

Rank	State	Total Reports	Rate per 1,000	Rate Rank
1	New York	5,932	108.99	#2
2	Florida	5,875	96.86	#4
3	California	5,100	50.48	#24
4	Pennsylvania	3,922	100.80	#3
5	New Jersey	2,768	83.76	#6
6	Texas	2,754	33.34	#30
7	Illinois	2,031	61.87	#17
8	Michigan	1,583	50.81	#22
9	Georgia	1,570	83.72	#7
10	Indiana	1,277	76.87	#8

The state with the third-highest total volume (5,100 reports), California, ranks only #24 by rate because its practitioner pool of 101,022 is the largest in the country. The state with the sixth highest volume, Texas (2,754 reports), ranks #30 by rate.

Methodology

This report uses medical malpractice payment reports from the National Practitioner Data Bank (NPDB), a federally maintained repository operated by the U.S. Department of Health and Human Services under the Health Care Quality Improvement Act of 1986. Malpractice payment reports for all 50 states were extracted from the NPDB public analysis tool for the calendar years 2021 through 2025, then aggregated by state for each individual year and across the full five-year period. To calculate the malpractice rate, total reports for each state were divided by the state’s total medical practitioner count over the same period and multiplied by 1,000, producing a standardized rate of malpractice reports per 1,000 practitioners. All 50 states were ranked from highest (#1) to lowest (#50) based on this rate. 

Data Sources

National Practitioner Data Bank (NPDB), Analysis Tool

U.S. Department of Health and Human Services

https://www.npdb.hrsa.gov/analysistool/ 

Research Dataset: Campaign 27 [Latest Data Reveals U.S. States With the Highest Medical Malpractice Rates] Data 

Study By: https://kitchellaw.com 

About Kitchel Law

Kitchel Law is a Washington, D.C. based legal practice led by attorney Allyson Kitchel, serving clients across the District of Columbia, Virginia, and Maryland. With nearly 20 years of experience in personal injury and civil litigation, the firm provides data-driven insights that inform public understanding of legal and safety issues.