As part of a national effort to understand the factors that contribute to medical malpractice costs and to understand how the handling of malpractice cases might be improved in the civil justice system, the Center for Court Innovation examined medical malpractice cases in three New York City counties between 2002 and 2010. The findings indicated that an array of factors contribute to malpractice case outcomes in court. Injury severity had a particularly strong relationship both to case outcomes and the size of any resulting monetary award. A variety of court case processing factors, including the influence of the presiding judge over how the case unfolded, also significantly predicted outcomes. The U.S. Department of Health and Human Services funded the study.