Bartow HMA, LLC v. Edwards
175 So. 3d 820
| Fla. Dist. Ct. App. | 2015Background
- Plaintiff Amber Edwards sued the Hospital and Dr. Larry Thomas for medical negligence after an alleged bile duct injury during cholecystectomy, asserting vicarious-liability and direct-negligence theories (e.g., negligent hiring).
- Edwards served broad discovery seeking documents from the five years before her surgery relating to the Hospital's investigations or reviews of Dr. Thomas and her own care, invoking Article X, § 25 (Amendment 7) as authority.
- The Hospital produced internal peer-review documents but withheld certain "Peer Review Report" documents prepared by an outside vendor (M.D. Review) at counsel’s request, logging them as privileged (attorney‑client/work product and peer‑review privileges).
- The trial court, after in camera review, ordered production of the external peer review reports, finding Amendment 7 preempted the asserted privileges for documents relating to adverse medical incidents.
- The Hospital petitioned for certiorari in the Second DCA challenging the order to produce the external peer review reports.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether external peer review reports are "made or received in the course of business" under Amendment 7 | Edwards: The reports are "Peer Review Reports" and relate to adverse incidents, so Amendment 7 authorizes access. | Hospital: Reports were prepared at counsel's direction for litigation and thus not made/received in the ordinary course of business. | Held: Not made/received in the course of business; prepared for litigation, so outside Amendment 7. |
| Whether external peer review reports qualify as "adverse medical incident" records under Amendment 7 | Edwards: Even if external, M.D. Review functions as a peer‑review equivalent and thus reports fall within the Amendment 7 definition. | Hospital: M.D. Review did not perform routine hospital peer review; reports were sporadic expert work for litigation, not part of the hospital's peer‑review/risk programs. | Held: Reports do not function as the hospital's peer-review committee records; context and purpose control; not within Amendment 7. |
| Whether Amendment 7 preempts common-law privileges (attorney-client and work product) as to these documents | Edwards: If documents are within Amendment 7, privileges are preempted and must be produced. | Hospital: Privileges protect the external reports; Amendment 7 does not reach attorney-client/opinion work product in this context. | Held: Court did not need to resolve full preemption issue because reports fall outside Amendment 7; given prior rulings, fact work product may be preempted but opinion work product and attorney-client preemption remain unsettled. |
| Whether trial court's production order departed from essential requirements of law (certiorari standard) | Edwards: Order correct because Amendment 7 grants access to any records relating to adverse incidents. | Hospital: Ordering production of privileged litigation‑generated external reports caused material injury and departed from law. | Held: Trial court departed from essential requirements by ordering production of the external reports; certiorari granted and order quashed in part. |
Key Cases Cited
- Bartow HMA, LLC v. Kirkland, 126 So. 3d 1247 (Fla. 2d DCA 2013) (discusses Amendment 7 preemption of peer‑review statutory protections)
- Lakeland Reg'l Med. Ctr. v. Neely ex rel. Neely, 8 So. 3d 1268 (Fla. 2d DCA 2009) (distinguishes litigation‑generated documents from regular peer‑review records under Amendment 7)
- W. Fla. Reg'l Med. Ctr., Inc. v. See, 79 So. 3d 1 (Fla. 2012) (interpreting statutory peer‑review confidentiality and committee deliberative materials)
- Brown v. Int'l Paper Co., 710 So. 2d 666 (Fla. 2d DCA 1998) (expert reports prepared for litigation not kept in ordinary course of business)
- Acevedo v. Doctors Hosp., Inc., 68 So. 3d 949 (Fla. 3d DCA 2011) (addresses Amendment 7 and treatment of work‑product privilege)
- Fla. Eye Clinic, P.A. v. Gmach, 14 So. 3d 1044 (Fla. 5th DCA 2009) (distinguishes opinion work product from fact work product post‑Amendment 7)
- Morton Plant Hosp. Ass'n, Inc. v. Shahbas ex rel. Shahbas, 960 So. 2d 820 (Fla. 2d DCA 2007) (discusses interplay of peer‑review protections and discovery)
- Yisrael v. State, 993 So. 2d 952 (Fla. 2008) (discusses records "kept in the ordinary course of a regularly conducted business activity")