By: Guy K. Noa, Esq.

Last week, the Florida Supreme Court ruled that a patient’s right of access under Amendment 7 to records related to “adverse medical incidents” was not preempted by federal law.

Article X, Section 25, of the Florida Constitution, also known as Amendment 7, was proposed by a ballot initiative, passed by more than 81% of Florida voters, and incorporated into the Florida Constitution in 2004.  It provides patients “a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident.”  “Adverse medical incident” is broadly defined as “any other act, neglect, or default of a health care facility or health care provider that caused or could have caused injury to or death of a patient.”  Essentially, the reports detail health care errors that caused or could have caused injury or death to a patient.

In 2005, Congress passed the Patient Safety and Quality Improvement Act (the “Federal Act”), which created a voluntary system of sharing data and health care errors for the purpose of improving patient safety and the quality of medical care.  Participating health care providers create a patient evaluation system in which relevant information regarding health care errors is collected and sent to a patient safety organization.  In turn, the patient safety organization provides feedback and recommendations to the healthcare provider on ways to improve patient safety and quality of care.  To encourage participation in the system by healthcare providers, Congress declared that the information collected and shared would be privileged and confidential under the Federal Act as “patient safety work product.”  Because the shared information could include adverse medical incident reports generated pursuant to Florida law, there was an apparent conflict between a patient’s right of access to the reports under the Florida Constitution, and the confidentiality protections afforded to healthcare providers under the Federal Act.  This apparent conflict was at issue in the Florida Supreme Court case, Charles v. Southern Baptist Hospital of Florida, Inc.

The case stemmed from a medical malpractice action initiated by Jean Charles Jr. on behalf of his sister, Marie Charles, and her minor children. The lawsuit alleged that Marie suffered a severe neurological injury due to Southern Baptist’s negligence.  During discovery, Charles filed requests for production pursuant to Amendment 7 seeking, among other things, adverse medical incident reports.  Southern Baptist withheld production of certain adverse medical incident reports, claiming that while the reports were potentially responsive to Charles’ requests, they were not subject to production because they were privileged and confidential under the Federal Act as patient safety work product.

In determining that the adverse medical incident reports were not protected under the Federal Act, the Florida Supreme Court reasoned that while the Act generally states that documents placed into a patient safety evaluation system that do not exist outside the system are privileged and confidential, the Act also makes numerous exceptions, particularly for information collected, maintained, or developed separately from a patient safety evaluation system.  The language of the Act also states that it does not affect a healthcare provider’s recordkeeping obligation under state law.

The Court reasoned that adverse medical incident reports were not patient safety work product because Florida law requires providers to create and maintain those reports and Amendment 7 provides patients with a constitutional right to obtain them.  Thus, the Court held, the reports fell within the exception for information collected and maintained separately from a patient safety evaluation system and the disclosure of the reports to patients “fits squarely within the provider’s recordkeeping obligations under state law.”  Accordingly, adverse incident reports could not be classified as protected patient safety work product under the Federal Act.

The Court further held that Amendment 7 was not preempted by the Federal Act, concluding that Congress never intended to preempt state laws or Amendment 7 through the Act’s passage.  Rather, “the clear intent of the Federal Act was for the voluntary reporting system to function harmoniously within existing state reporting and discovery laws” and “to improve the overall health care in this system, not to act as a shield to providers, thereby dismantling an important right afforded to Florida citizens through Amendment 7.”

The Supreme Court’s holding is important as Amendment 7 provides critical information for injured parties who have filed a medical malpractice suit as a result of negligent care, and it also allows individuals to make informed decisions when choosing health care providers.

If you or a loved one were injured by medical malpractice, please contact us for a free consultation.

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