Total cases in the last two years have been far below the 69 filed in 2002. Similarly, the number of cases filed statewide in 2003 and 2004 was at least one-third lower than 2002, when several state reforms were enacted to make it more difficult for malpractice cases to enter the court system.

The Supreme Court required plaintiffs to obtain certificates of merit from other doctors before filing cases, and a new law prohibited "venue shopping" that would put cases in front of favorable juries in other counties.

"This clearly shows the reforms that were put into place are working," said Paul Lyon, executive director of a local plaintiffs' attorney advocacy group, Committee for Justice for All.

Luzerne County, meanwhile, reported 79 case filings in 2004, compared to 38 in 2003.

Last year's count is likely inflated because Luzerne County did not specially mark malpractice cases until this year, Luzerne County Prothonotary Jill Moran said. As a result, Luzerne reported 61 cases against doctors or hospitals that may or may not be malpractice cases.

"There was no way of knowing at the time we filed those reports whether these were malpractice cases," Ms. Moran said.

A lobbying group for physicians said the statewide drop in case filings is welcome news but noted that total payouts from malpractice cases rose in 2004.

"Payouts are up, but claims are down," said Charles Moran, spokesman for the Pennsylvania Medical Society. The state reforms in 2002 "address the issue of frequency, but not severity of awards," he said.