Florida Hosp. Waterman, Inc. v. Buster
984 So. 2d 478, 2008 WL 596700 (2008)
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Rule of Law:
A voter-approved constitutional amendment granting patients a right of access to records of adverse medical incidents is self-executing and applies retroactively to records created before its passage. Statutory confidentiality protections for such records do not constitute a vested right that would prevent retroactive application.
Facts:
- Teresa M. Buster and Evelyn Bowen received medical care at Florida Hospital Waterman and Notami Hospital of Florida, respectively.
- Subsequently, Buster and Bowen each filed medical malpractice lawsuits against the hospitals where they received treatment.
- During the lawsuits, Buster sought records related to the hospital's investigation of her specific adverse medical incident.
- In her case, Bowen sought records concerning the hospital's selection, retention, or termination of a particular physician.
- Both hospitals objected to producing the requested records, claiming the documents were confidential and privileged under various Florida statutes predating a new constitutional amendment.
- In November 2004, Florida voters approved a ballot initiative known as Amendment 7, creating a new constitutional right for patients to access any records relating to adverse medical incidents.
Procedural Posture:
- Teresa Buster sued Florida Hospital Waterman, Inc., and Evelyn Bowen sued Notami Hospital of Florida, Inc., in separate medical malpractice actions in Florida trial courts.
- In both cases, the trial courts granted the plaintiffs' motions to compel production of adverse medical incident records, ruling that Amendment 7 was self-executing and applied retroactively.
- Both hospitals sought review of the trial court orders by filing petitions for a writ of certiorari in their respective intermediate appellate courts.
- The Fifth District Court of Appeal, in the 'Buster' case, held that Amendment 7 was self-executing but did not apply retroactively to records created before its passage, and it certified questions of great public importance to the Florida Supreme Court.
- The First District Court of Appeal, in the 'Notami Hospital' case, held that Amendment 7 was self-executing, applied retroactively, and that the legislative statute implementing it was unconstitutional. It certified conflict with the Fifth District's decision in 'Buster'.
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Issue:
Does Article X, section 25 of the Florida Constitution (Amendment 7), which grants patients a right of access to adverse medical incident records, apply retroactively to records created before its effective date?
Opinions:
Majority - Per Curiam
Yes, Article X, section 25 of the Florida Constitution applies retroactively to records created before its effective date. The amendment is self-executing because it lays down a 'sufficient rule' for its enforcement, defines all key terms, and provides for an immediate effective date, indicating it does not require legislative action to be effective. In analyzing retroactivity, the court found clear intent for it to apply to existing records based on the amendment's plain language, which grants access to 'any records' relating to 'any adverse medical incident' and defines 'patient' to include individuals who have 'undergone care.' The ballot summary and stated purpose also demonstrate an intent to remove existing statutory restrictions on a provider's 'history' of such incidents. Retroactive application is constitutionally permissible because the prior statutory confidentiality of peer review records did not create a vested, substantive right for the hospitals. Instead, it was a statutory policy subject to legislative change, creating at most an 'expectation' that the law would continue, not a fixed right immune from constitutional override.
Dissenting - Wells, J.
No, Article X, section 25 of the Florida Constitution should not be applied retroactively. There is a strong legal presumption against the retroactive application of laws that affect substantive rights. The amendment's text does not contain the clear and explicit statement of retroactive intent required to overcome this presumption. The statutory scheme that protected peer review records created a substantive right and a discovery privilege, which this Court previously recognized as essential for encouraging candid self-regulation by the medical profession. Healthcare providers relied on the state's promise that these records would be confidential. Applying the amendment retroactively breaks this promise, which is fundamentally unfair and undermines the settled expectations upon which the peer review process was built. This decision jeopardizes the stability of all statutory privileges by making them contingent on the law never changing.
Analysis:
This decision solidifies a significant public policy shift in Florida, prioritizing patient transparency over the long-standing confidentiality of healthcare provider peer review. It establishes that a constitutional amendment passed by citizen initiative can retroactively eliminate statutory protections if the intent is sufficiently clear from its language and purpose, even without using the word 'retroactive.' This ruling empowers voters and limits the legislature's ability to narrow the scope of citizen-led constitutional changes, setting a powerful precedent for future conflicts between constitutional rights and statutory privileges.
