A state appellate court has determined that an “investigate report” related to a hospital visitor’s slip and fall injury is privileged under the Patient Safety and Quality Improvement Act of 2005 (PSQIA). Although the title of the act reads “Patient Safety and Quality Improvement,” the court acknowledged that the PSQIA also protects reports related to injuries involving persons other than those receiving services from a health care provider.
The PSQIA creates a voluntary program through which health care providers can share information relating to patient safety events with patient safety organizations with the aim of improving safety and quality of care nationwide. The PSQIA attaches privilege and confidentiality protections to this information without fear of liability. ABA Litigation Section leaders agree with the court’s ruling. In their opinion, the objectives of the PSQIA were furthered and the court’s ruling is in line with a clear reading of the statute.
In Shands Teaching Hospital and Clinics, Inc. v. Beylotte, the plaintiff brought a negligence suit against Shands Teaching Hospital and Clinics after she slipped and fell while visiting a patient at the hospital. The plaintiff sought discovery of an “investigative report” that the hospital prepared as a result of her fall. The hospital contended that the report was not discoverable, and the plaintiff moved to compel its production.
The hospital argued that the report was placed in the hospital’s patient safety evaluation system, “prepared solely for submission to [a] patient safety organization[,]” and was eventually submitted. The hospital therefore claimed that the report was protected by the PSQIA. The trial court disagreed and granted the plaintiff’s motion to compel, reasoning that the PSQIA only applies to patients—not to staff or visitors. The hospital filed a petitioned for certiorari.
The Florida First District Court of Appeal reversed the trial court’s decision. The appellate court noted that the hospital’s uncontradicted affidavit provided that “the subject report was assembled for reporting to a patient safety organization under the act and the report was in fact submitted” pursuant to the reporting procedure under the PSQIA. Because of this, and because the report could result in improved patient safety, the court determined that it was privileged and confidential under the PSQIA. The court quashed the trial court’s order requiring disclosure of the report.
The court’s decision derives from a clear reading of the PSQIA, and Section leaders believe the court got it right. “Because the hospital actually did submit the report to a safety organization, the report was protected, despite the plaintiff’s status,” states Valerie Fontenot, New Orleans, LA, cochair of the Section’s Health Law Litigation Committee. “The PSQIA is geared towards patient safety, and in this particular case, patient safety could have been impacted regardless of the plaintiff’s status as a visitor,” Fontenot points out.
“As a matter of policy, the court’s decision was not spot on,” suggests Joseph V. Schaeffer, Pittsburg, PA, cochair of the Section’s Pretrial Practice & Discovery Committee. “However, the court’s rationale aligns with what the statute provides,” Schaeffer says. “Interestingly, there is no definition of ‘patient’ in the PSQIA. Therefore, the application of the privilege does not have to be directly related to a patient at the hospital,” notes Shaeffer.
This decision should further the goal of honest reporting by health care facilities. “Providers are correcting issues that need addressing in order for their patients to be in the safest environment possible,” states Fontenot. “If the reports become public, people are probably not going to report as truthfully or report as often,” she predicts. “In fact, this ruling encourages providers to be more thorough while investigating incidents, since they would not have to produce the report to show what they did,” Fontenot concludes.
Other Section leaders note that the safety of hospital patients and visitors are connected. “This decision encourages a policy of self-reflection and allows for the hospital to take a look at the cause of the incident without fear that it might be used against them in litigation down the road,” explains Schaeffer. “This would lead to improved safety outcomes for everyone,” Schaeffer adds, “because an analysis of a visitor’s slip and fall could affect patient safety.”
