Unapproved and Off-Label Use of Drugs in a Children's Hospital

To the Editor: The findings of Cassidy et al. (April 20 issue) 1 suggest that radical changes are needed in the tort system of automobile insurance that is common throughout the United States, in which injured claimants can sue for pain and suffering caused by another driver's negligence. Cassidy et al. examined the time to closure of a claim for claimants injured in motor vehicle collisions in Saskatchewan, Canada, during the six months before January 1, 1995, when a tort system was in effect, and in the two consecutive sixmonth periods after that date, when no-fault insurance was implemented. Under the no-fault system, claimants could no longer claim compensation for pain and suffering. The time to closure of claims was reduced by 54 percent during the no-fault period. The authors conclude that the reduction in the duration of whiplash injuries under the no-fault system was due to the absence of the financial incentive that is inherent in the tort system.