Medical Records Fight Draws Attention At High Court

In a legal battle drawing attention from medical groups across the country, the U.S. Supreme Court could be close to deciding whether to hear a Florida case about the disclosure of medical records.

The Supreme Court is expected to consider the case Monday during a private conference, according to an online docket. The court receives thousands of petitions a year but agrees to hear only a relative handful of cases.

The Florida case focuses on whether hospitals are required to disclose certain records to plaintiffs during medical-malpractice lawsuits — or whether those records are shielded by a federal patient-safety law. Southern Baptist Hospital of Florida, Inc., which operates as the Baptist Health System in the Jacksonville area, filed a petition in May asking the U.S. Supreme Court to take up the case after the Florida Supreme Court ruled that disputed records should be disclosed.

The state Supreme Court decision was rooted in a 2004 Florida constitutional amendment, which was backed by plaintiffs' attorneys and was intended to provide access to what are known in the health-care industry as "adverse medical incident" reports. The Baptist system and its supporters, however, argue that at least some records are shielded from disclosure by the federal law.

While the case involves the interplay between the voter-approved Florida constitutional amendment and the federal law, it has drawn friend-of-the-court briefs at the U.S. Supreme Court from groups such as the American Medical Association and the American Hospital Association — along with Florida medical groups and hospitals backing the Baptist system.

The federal law, the 2005 Patient Safety Act, allows hospitals to voluntarily submit information about medical errors to what are known as "patient safety organizations" — and 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.

The Baptist system and its supporters say the Florida Supreme Court ruling threatens that system and contend federal law should trump state law on the disclosure issue.

“The effects of the Florida Supreme Court's decision are not, and will not be limited, to Florida,” said a friend-of-the-court brief led by the American Medical Association and the Florida Medical Association and joined by dozens of other medical groups and providers. “Indeed, hospitals and providers across the nation, particularly those physician and hospital provider groups that are located in multiple states, depend upon a uniform and predictable privilege when collecting and reporting patient safety work product to PSOs (patient safety organizations).”

The underlying lawsuit that led to the records fight was filed against the Baptist system by the family of patient Marie Charles and alleged that negligence in her care caused a severe neurological injury, according to court documents.

Attorneys representing the Charles family argued in a brief last month that the U.S. Supreme Court should not take up the case. They also raised the possibility that hospitals could use the federal Patient Safety Act to wrongfully prevent the release of records.

“Petitioner's (the Baptist system's) reading of the act contravenes the plain language of the statute and legislative intent because it grants unprecedented, unchecked power to providers to conceal information,” said the brief, which along with the others is posted on the website SCOTUSblog. “It empowers a provider to unilaterally transform virtually any information — collected, maintained, or developed pursuant to a non-Patient Safety Act law — into privileged patient safety work product by simply reporting that information to the patient safety organization. This is an abuse of the federal privilege.”

A twist to the case is that the Charles family and the Baptist system reached a settlement on the eve of a Florida Supreme Court hearing in the dispute. But the Florida Supreme Court decided to continue with the case and, ultimately, ruled against the hospital system.

In their brief last month, attorneys for the Charles family said the U.S. Supreme Court should not hear the case because of the settlement.

“Petitioner's attempt to invoke this (U.S. Supreme) Court's equitable power to vacate a judgment in a moot case fails,” the brief said. “Petitioner mooted this case by its own action — settling the case.”

But in a brief this month, the Baptist system disagreed, saying “nothing about the settlement” alters the consequences of the Florida Supreme Court ruling.

“When Florida courts order Baptist to produce federally-privileged work product, Baptist cannot resist based on its private agreement with respondents (the Charles family),” the brief said. “That the parties tried — and failed —  to end these proceedings does not change that the state court rejected their stipulation of dismissal and issued a 32-page opinion deciding this question of `great public' and `statewide' importance.”

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