Judge rules against hospital in medical records dispute


FILE – In this Dec. 20, 2011 file photo, medical bills and other records are spread out on the kitchen table of a patient in Salem, Va. According to a 2018 national survey released on Wednesday, Feb. 12, 2020, just over 14 percent of people said they belonged to a family struggling with medical bills. That’s a big drop from nearly 20 percent in 2011 but only slightly less than the proportion who reported the problem in 2016 and 2017. (AP Photo/Don Petersen, File)

TALLAHASSEE, Fla. (The News Service of Florida) — In the second similar ruling in recent months, a federal judge has rejected a Jacksonville hospital’s arguments in a case about whether it should be shielded from being required to turn over records to a patient in a medical-malpractice dispute.

The ruling last week by U.S. District Judge Timothy Corrigan against UF Health Jacksonville is part of years of legal battles stemming from a 2004 Florida constitutional amendment that was designed to provide access to medical records in malpractice cases.

In March, U.S. District Judge Allen Winsor ruled against UF Health Shands, part of the same health-care system as UF Health Jacksonville, in a similar case. UF Health Shands has taken that case to the 11th U.S. Circuit Court of Appeals in Atlanta.

The cases focus heavily on the interplay between the 2004 state constitutional amendment and a 2005 federal law that provides confidentiality protections for certain medical records. Hospitals have argued that they should not be forced to disclose some records in malpractice cases because of the federal law — and could be fined for doing so.

But the Florida Supreme Court in 2017 rejected the idea that the federal law trumps the state constitutional amendment, which was passed amid a major feud between doctors and plaintiffs’ attorneys about medical-malpractice laws. Plaintiffs’ attorneys largely funded the drive to pass the amendment.

UF Health Jacksonville filed a lawsuit last year asking Corrigan to declare that disputed records sought by Nadia Caro, who had been a patient at the hospital, were shielded by the federal law. The lawsuit named as defendants Caro and U.S. Department of Health and Human Services Secretary Alex Azar, whose agency would have enforcement power over violations of the federal law.

The 2004 constitutional amendment was intended to provide access for patients and their attorneys to what are known as “adverse medical incident reports,” which can play an important role in malpractice cases. The 2005 federal law allows hospitals to voluntarily submit information about medical errors to “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.

UF Health Jacksonville contended, in part, that handing over records sought by Caro would violate the federal law and could subject it to penalties.

Corrigan framed the case as presenting “questions concerning federalism and the relationship between federal and state courts.” But in dismissing it, Corrigan ruled that he lacked “subject matter jurisdiction” to address the issue of whether the federal law preempts the state constitutional amendment.

In part, Corrigan wrote that UF Health Jacksonville, which also is known as Shands Jacksonville, has not faced penalties from the federal agency — and is unlikely to face such penalties in the future if disputed documents are turned over.

“HHS has sole authority to impose sanctions for violating the federal act and, per its counsel at the hearing, it has never done so in the 15 years since the federal act’s passage,” Corrigan wrote in the 14-page ruling. “Despite arguing that the penalty provisions are mandatory, Shands admitted at the hearing that other hospitals have produced PSWP (documents known as patient safety work product) without being penalized by HHS. Thus, even if the string of contingent, necessary prerequisites occur — Caro requests privileged documents, the state court orders Shands to produce them, and Shands produces them — it is unlikely that HHS will impose sanctions against Shands.”

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