Two changes to the medical malpractice laws in 2003 have had a major impact on how many lawsuits are initiated in Pennsylvania and where they are filed, according to an article in The Daily Item newspaper in Sunbury, Pa. In 2003, the state Supreme Court ruled that potential plaintiffs have to obtain a certificate of merit by a medical professional establishing that what happened in the case fell outside of the acceptable standards of care. This change has accounted for a decrease in frivolous claims and in claims that have little likelihood of success. Since 2003, medical malpractice lawsuits in the state have dropped by 39%. However, a second change by the Supreme Court has resulted in a 60% increase in malpractice lawsuit filings in the Columbia-Montour judicial district. This is because in 2003, the state Supreme Court required medical malpractice actions to be brought only in the county where the alleged mistake took place, and the Columbia-Montour judicial district is home to a large medical center and hospital. The court ruling was designed to eliminate “venue-shopping,” the process by which attorneys would try to have cases heard in areas where jurors might be more sympathetic.