As Ms Hofler stated very well in her article,1 statutory protection is needed to guarantee the confidentiality of peer-review committee members and the committee's records. This confidentiality was granted by the federal government under the Health Care Quality Improvement Act (HCQIA) of 1986, Section 427b(1)(2), to promote freely self-evaluation among healthcare providers, thus improving quality and patient safety.

In Florida, the confidentiality of the peer-review committees' records was protected under Cruger v Love (599 So 2d 111) and the Florida Statutes (1989) sections 766.101 and 395.011. Unfortunately, this immunity is gone with the approval of Amendment 7: Patients Right to Know About Adverse Medical Inci-dents, in the November 2004 state-wide elections.

Amendment 7 was sponsored by the Floridians for Patient Protection, the political action committee of the Academy of Florida Trial Lawyers. The amendment's intent is easily gleamed from the purpose statement: [horizontal ellipsis]to create a constitutional right for a patient or potential patient to know and have access to records of a health care facility's or provider's adverse medical incidents, including medical malpractices and other acts which have caused or have the potential to cause injury or death.

As expected, from the date Amendment 7 was passed, plaintiff attorneys have bombarded hospitals requesting peer-review notes. Some requests have been as absurd as requesting all adverse incidents reports in the hospital's history. Needless to say, in Florida, the future of patient safety and quality improvement switched from the hands of healthcare providers to those of senators and representatives who are in the process of transforming the amendment into enacted legislation-Bills SB 2218 and HB 1797.

Legislators and advocates for healthcare providers in Florida need to evaluate carefully the applicability of these bills since these clearly violate the confidentiality of the peer-review records. According to the HCQIA, violators of this confidentiality will be subject to civil penalties up to $10,000 for each violation. Healthcare providers need clarification in reference to what legislation supersedes, federal or state level.

Claudia Ritter, BA, MHA

Lakeland, Fla

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