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Federal Law Trumps State Law When it Comes to Access to Medical Records

In late October, the Federal First District Court of Appeal in Florida ruled that a Florida constitutional provision mandating disclosure of adverse medical incidents is superseded by the federal Patient Safety and Quality Improvement Act. This means that Florida citizens can be denied access to crucial medical records regarding their malpractice claims even though they are guaranteed access by the state constitution.

This ruling will have deep ramifications throughout the state of Florida upon anyone seeking compensation for poor medical care. Winning a malpractice suit relies heavily on access to quality information detailing just what went wrong with the patient’s care and now the federal government is denying this right to Floridians.

Florida has some of the most open public records laws in the country so it is not necessarily surprising that these laws are butting with the federal ones. But in this incident where the records can be so vital in proving patterns of negligence and misconduct in hospitals, affecting patients’ health and quite literally their lives, it is unconscionable that these documents can be hidden from the public. This gross mischaracterization of justice will hopefully be remedied if the case moves to higher courts.

About the Case

In the case of Baptist Hospital of Florida, Inc. v. Jean Charles, Jr., the plaintiff, Jean Charles, Jr. sued Baptist Hospital for medical negligence regarding a neurological injury of his sister. In the discovery phase of the trial, Charles attempted to retrieve documents pertaining to various adverse medical incidents occurring at the hospital in the three years prior to the injury. Charles, who is the appointed guardian of his sister and her three children, alleged that his sister suffered from a catastrophic neurological injury due to the hospital’s negligence.

Charles and his legal counsel filed three requests with the hospital for documents pertaining to adverse medical occurrences at the hospital and documents “either related to any physician who worked for Baptist or arose from care and treatment rendered by Baptist” in the three years before the injury. The hospital retrieved some of the requested documents including the ones relating to Charles’ sister’s care but claimed other adverse medical occurrence documents were privileged and confidential under federal law.

The Florida Constitutional Provision

Adopted in 2004, Article X, §25, of the Florida State Constitution grants patients a right to know about adverse medical incidents. Adverse medical incidents are 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.”

The provision gives patients the ability to request medical documents about any adverse medical incidents occurring at the medical care facility, not just the ones that apply to their particular medical malpractice claim. A patient, as defined by the provision, means any person who is seeking, is undergoing or has undergone medical treatment at the medical care facility.

The Federal Law

In direct opposition to this Florida provision comes the Patient Safety and Quality Improvement Act. This law passed in 2005 was intended to reduce medical errors and increase patient safety by aggregating and analyzing confidential medical records to find evidence-based best practices to make hospitals and other medical institutions safer.

The reasoning behind the act was that hospitals were underreporting adverse medical incidents for fear of medical malpractice suits. The law intended for this information to only be sent to federal organizations so that hospitals had nothing to lose by both cataloguing and reporting these incidents.

In order to ensure that medical institutions would not fear that this data could be used against them, the law created a protected legal environment around the information, deeming them both classified and privileged. To comply with state medical information reporting statutes, medical providers are required to keep the information in one protected database until the provider determines it must be removed and given to the state. This part of the law essentially became the deciding factor in the aforementioned case.

Although the law is well intentioned, it is a very top down way of improving hospitals. It relies on the federal government to pressure or encourage hospitals to improve safety while limiting an individual’s right to do so.

The Ruling

As federal courts tend to do, the District Court of Appeals ruled that federal law preempts state law. The judges stated that although the hospital was required to collect certain patient safety information under state law, according to the Patient Safety and Quality Improvement Act, the information remained classified until it was actually reported to the state. This means that only the state of Florida can get access to the information but not its citizens.

The ruling, however, has not been made permanent. The plaintiff still has time to file a motion of rehearing. If the case moves forward it would be heard before the Florida Supreme Court.


This decision is a loss for anyone in the state of Florida who is the victim of medical malpractice. With less access to information to hospital records, proving negligence will be more difficult, but obviously not impossible. Medical malpractice will always be an issue as long as there is a human touch to medical care and unfortunately there will always be patients suffering as a result. Although not all medical information can be retrieved as per the judge’s ruling, there are still plenty of other ways to prove that you were the victim of medical negligence. If you have a serious claim, legal remedies can always be afforded in Florida especially with a qualified attorney.

Contact an Experienced Medical Malpractice Attorney Today

If you or a loved one was seriously harmed by a doctor, surgeon, nurse, other medical professional, contact the experienced Florida medical malpractice attorneys at the Pendas Law Firm. Our team of attorneys will take the time to review your medical records to determine whether a mistake or negligent act occurred and request all available information pertaining to your case. We can also discuss your legal options during a free, confidential consultation.

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