In 2000, R. Ray Pate Jr., then the president and chief executive of medical malpractice insurer NCRIC Inc., threatened a “train wreck” if Columbia Hospital for Women Medical Center didn’t pay up during a $3 million dispute over policy payments. Not only did the train wreck, it veered completely off the rails.

Columbia, which opened in 1866 to treat wives and widows of Civil War soldiers, closed its doors in 2002. Hospital administrators blamed the malpractice-insurance debacle for the demise of the 86-bed nonprofit hospital, where more than 275,000 babies were delivered over 136 years of continuous operation.

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