In the realm of medical malpractice litigation, the current trend toward nuclear verdicts and an emboldened plaintiffs bar is causing concern for healthcare providers and insurers. Nuclear verdicts, which refer to settlements in the 8-9 figure range, have become increasingly common in recent years. As a result, the plaintiffs bar is shifting away from settlements in the hopes of obtaining a nuclear verdict at trial. This shift is not only costly, but also time-consuming for all parties involved. Further, the settlements that can be achieved are increasing at a rate faster than typically expected with inflation. As a result, defense counsel need be aware of the shift in practice and respond with even more aggression and tenacity.