Justices rule medical documents must be disclosed

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Jacksonville hospital system required to provide records to a patient's family

By Jim Saunders, News Service of Florida

TALLAHASSEE, Fla. - In a ruling that could have implications for medical-malpractice cases across the state, the Florida Supreme Court on Tuesday said a Jacksonville hospital system was required to provide records to a patient's family because of a 2004 constitutional amendment.

The 5-2 ruling overturned a decision by the 1st District Court of Appeal, which said a federal patient-safety law shielded the hospital system from having to turn over some documents in a malpractice lawsuit. The ruling stemmed from a voter-approved ballot initiative, known as Amendment 7, that was designed to expand access to records in malpractice cases.

"The federal act was intended by Congress 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," said the majority opinion, written by Justice Barbara Pariente and joined by Chief Justice Jorge Labarga, justices R. Fred Lewis and Peggy Quince and Senior Justice James E.C. Perry. "Moreover, health care providers should not be able to unilaterally decide which documents will be discoverable and which will not in medical malpractice cases."

But Justice Charles Canady, in a dissenting opinion joined by Justice Ricky Polston, wrote that the Supreme Court should not have ruled in the case. That is because the family of patient Marie Charles and Southern Baptist Hospital of Florida, Inc., which does business as the Baptist Health hospitals, reached a settlement on the eve of Supreme Court arguments in October.

"The decision of the majority here, which can have no impact on this settled case, is a purely advisory opinion," Canady wrote. "Our job is to decide live controversies presented by the parties to a case that is before us. It is not to opine on the issues in a case that has been settled and that the parties have agreed should be dismissed."

But the majority, in a footnote, pointed to broader implications of the case.

"After briefing in this case was complete and the day before oral argument, the parties filed a stipulation of dismissal, which we rejected because this case not only involves an issue of statewide importance, but also involves a decision of the 1st District holding that (part) of the Florida Constitution has been preempted by federal law and is therefore invalid," the footnote said. "Absent an opinion from this (Supreme) Court, all trial courts in this state would be bound by the opinion of the 1st District, until there is a contrary decision from the appellate court in their own district."

Charles' family filed a lawsuit against the health system alleging that negligence in her care caused a severe neurological injury, according to Tuesday's ruling.

Records held by hospitals and other medical providers can play a key role in medical malpractice cases. The 2004 constitutional amendment, which was backed by plaintiffs' attorneys, was intended to provide access to what are known as "adverse medical incident" reports.

But the Baptist system argued it should not have to turn over some documents in the Charles case because of a 2005 federal law. The law allows hospitals to voluntarily submit information about medical errors to what are known as "patient safety organizations" --- and also offers certain confidentiality protections. The law was aimed, at least in part, at encouraging health providers to submit information that could be analyzed and used to prevent future medical errors.

While the 1st District Court of Appeal agreed with the health system's arguments, the Supreme Court majority said the federal law was not meant to "preempt" state requirements for disclosing information.

"Amendment 7, which was enacted before the federal act, gives patients a constitutional right to broad access to adverse medical incident records," Pariente wrote. "This citizen-initiated constitutional amendment 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 future health care providers. Thus, this area of regulation is directly within the states' traditional role of regulating the health, safety, and welfare of its citizens."

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