Litigation Against Physicians Caring for Collegiate Athletes in the United States.

Background: Physicians caring for collegiate athletes practice in a high-stakes environment where return-to-play decisions and delayed diagnoses may increase exposure to malpractice claims. Despite growing medicolegal concern, litigation involving physicians caring for collegiate athletes has not been comprehensively characterized. Purpose/Hypothesis: The purpose was to characterize negligence claims against physicians caring for collegiate athletes and assess temporal trends, allegations, and outcomes. The hypothesis was that there would be an increase in cases against physicians caring for collegiate athletes in recent years. Study Design: Cross-sectional study. Methods: A search of publicly available legal databases, court records, and news archives was conducted in December 2025 to identify litigation claims involving physicians caring for collegiate athletes in the United States. Cases were included if a physician was named as a defendant. No restrictions on case year were applied. Case characteristics, allegations, outcomes, and monetary awards were abstracted. Awards were inflation adjusted to 2026 US dollars. Data were presented descriptively. Results: Thirty cases met inclusion criteria. The number of identified litigation cases increased over time, with a greater concentration of cases in more recent decades. Most defendants were male (93%) and team physicians (61%), with orthopaedic surgery being the most common specialty (41%). The most frequent allegations, expressed as a proportion of all recorded allegations, were improper/inadequate treatment (27%), negligent medical clearance (19%), and failure to diagnose (18%). Outcomes favored the defense in 60% of cases, while 23% resulted in plaintiff verdicts or settlements. The mean inflation-adjusted award in plaintiff-favorable cases was $2.02 million. Conclusion: The current study demonstrated that based on publicly available data, a limited number of litigation cases involving physicians caring for collegiate athletes were identified, with more cases observed in recent decades. Although most cases favor the defense, plaintiff-favorable outcomes involve substantial financial exposure. These findings are based on publicly available cases and may overrepresent litigated outcomes, but they highlight the importance of accurate diagnosis, prudent return-to-play decision making, a multidisciplinary approach to care, and proactive risk mitigation in the management of collegiate athletes.