An intermediate level appellate court in Florida last year held that patient safety information can be shielded from disclosure in a medical liability case. Now, that same case is on appeal—this time, in the Supreme Court of Florida.
What happened last year
In Southern Baptist Hospital of Florida, Inc. v. Charles, a trial court had ordered the release of medical documents used for patient safety and quality improvement efforts as part of litigation discovery. Then, in October of last year, a Florida district court of appeal overturned the trial court’s decision and found that health care information, which was being used for patient safety improvement efforts, was privileged from discovery.
The district court of appeal held that the Patient Safety and Quality Improvement Act of 2005 (PSQIA) preempted a provision in the Florida constitution.
The PSQIA enables physicians and hospitals to share medical information used for quality improvement through a patient safety organization (PSO). The data within these systems is deemed privileged under the PSQIA, with the exception of requests that state administrative agencies might make for the information. If this information is not protected from litigation discovery, it could stifle the sharing of information and impeded upon quality and patient safety improvements.
PSOs were established to gather and analyze information critical to the improvement of patient safety and quality of care. The information is submitted to PSOs in accordance with the PSQIA and is protected from disclosure as a patient safety work product (PSWP).
The district court of appeal’s decision allowed for continued confidential sharing of patient safety information without fear of disclosure in medical liability litigation.
Protected patient safety information again under threat
Now on appeal in the Supreme Court of Florida, the case is focused on documents prepared as the result of a state legal requirement.
Both sides are in agreement on one thing: Physicians and hospitals must under some circumstances submit patient safety information upon request from a state agency—even with the protections afforded to PSWPs.
The twist in this particular case is that the PSWP information, although prepared as the result of a state agency requirement, was never submitted to the state agency because the agency did not request it.
The question before the Florida Supreme Court is whether, under the PSQIA, if the state agency does not request the PSWP documents from a physician or hospital, those documents will be protected from disclosure in medical liability litigation.
A reversal of the First District Court of Appeal holding would “effectively nullify the PSQIA in the state of Florida,” the Litigation Center of the AMA and State Medical Societies said in an amicus brief.
“This court’s reversal of the First District’s ruling in this case,” the brief said, “would undo the progress made to date and undermine the valuable work that has been done by PSOs and their member health care providers. Patients, who are the ultimate beneficiaries of the PSQIA, would suffer.”
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