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As part of the Tort Reform Act of 1986, Connecticut’s legislature required for all medical malpractice complaints a certificate signed by the plaintiff’s lawyer that a reasonable inquiry into the merits of the claim was made and that there is a good faith basis for the lawsuit. In 2005, the legislature bolstered that effort by also requiring in General Statutes § 52-190a the filing of a written opinion of a “similar health care provider” that “there appears to be evidence of medical negligence.” This written opinion requirement has generated a wave of litigation. Counsel should consider this developing area of the law carefully at the outset of a case, as the issues can be dispositive.