Title: Florida Department Of Corrections v. Lisa M. Abril, Et Vir.

State: florida

Issuer: Florida Supreme Court

Document:

Supreme Court of Florida 
 
 
 
 
____________ 
 
No. SC04-1747 
____________ 
 
 
FLORIDA DEPARTMENT OF CORRECTIONS,  
Petitioner, 
 
vs. 
 
LISA M. ABRIL, et vir,  
Respondents. 
 
[October 18, 2007] 
 
PER CURIAM. 
This case is before the Court pursuant to a certified question of great public 
importance from the Second District Court of Appeal.  We have jurisdiction.  Art. 
V, § 3(b)(4), Fla. Const.  The appellee, Lisa M. Abril, sought damages based upon 
negligence in the unauthorized disclosure of the results of her HIV testing.  Abril 
v. Dep’t of Corr., 884 So. 2d 206, 207-08 (Fla. 2d DCA 2004).  The district court 
reversed the trial court’s dismissal of the case for failure to state a cause of action.  
Id. at 213.  In reinstating the case, the Second District certified the following 
question to this Court as one of great public importance: 
IS FLORIDA’S IMPACT RULE APPLICABLE IN A CASE IN 
WHICH IT IS ALLEGED THAT THE INFLICTION OF 
EMOTIONAL INJURIES HAS RESULTED FROM A CLINICAL 
LABORATORY’S BREACH OF A DUTY OF 
CONFIDENTIALITY UNDER SECTION 381.004(3)(f), FLORIDA 
STATUTES (SUPP. 1996), WITH RESPECT TO HIV TEST 
INFORMATION? 
 
Id.  While not approving all of the reasoning, we approve the district court’s 
ultimate decision, answer the certified question in the negative, and hold that an 
entity that negligently and unlawfully violates a patient’s right of confidentiality 
and privacy in disclosing the results of HIV testing of the patient may be held 
responsible in a civil negligence action for damages caused to the patient by the 
unlawful disclosure. 
Proceedings to Date 
The prior proceedings were summarized by the district court in the opinion 
below: 
The amended complaint alleged that Mrs. Abril, in the course 
of her employment with the department as a senior licensed practical 
nurse at the Hendry County Correctional Institution [(HCCI)], had 
given unprotected mouth-to-mouth resuscitation to an inmate.  After it 
was determined that the inmate was infected with hepatitis C and that 
it was unknown whether the inmate was infected with HIV, Mrs. 
Abril unsuccessfully sought testing for hepatitis and HIV through the 
department’s workers’ compensation carrier, which declined to 
authorize the testing because it determined that the resuscitation did 
not expose her to a risk of infection.  Subsequently, the institution’s 
chief medical officer submitted a blood sample from Mrs. Abril to 
Continental Laboratory, a laboratory under contract with the State of 
Florida to provide clinical laboratory services for inmates for HIV 
testing.   
 
2
The complaint further alleged that a document indicating that 
the test results for HIV were positive was faxed to an unsecured fax 
machine in the institution’s business office and to another fax machine 
in Tallahassee at the [Department of Corrections’] offices of Chief 
Health Services, despite Continental Laboratory’s assurances set forth 
in a prior fax to a “confidentially-secured” fax machine in the 
institution’s medical office that the results of the test were confidential 
and would be hand delivered.  It was alleged that the faxes with the 
test results were sent in response to a request for the information from 
a department employee who was concerned that the use of Continental 
Laboratory for the testing of Mrs. Abril’s blood might not have been 
authorized.  The complaint also alleged that a number of persons 
employed by the department, who were not authorized by law to know 
of the test results, became aware of the test results through 
Continental Laboratory’s transmission of the results to the fax 
machines.  It was ultimately determined through testing, paid for by 
the workers’ compensation carrier, that Continental Laboratory’s HIV 
test on Mrs. Abril’s blood had produced a false positive and that Mrs. 
Abril had not in fact contracted HIV.   
Id. at 207.  The Abrils subsequently filed a civil action, seeking damages, in part, 
for the mental anguish and emotional distress suffered by Ms. Abril arising from 
Continental’s negligent failure to ensure the confidentiality and privacy of the HIV 
test results1 and the subsequent negligence of Continental and the Department of 
Corrections in causing the test results to be improperly disseminated to others.  Id. 
at 207-08.2     
                                          
 
 
1.  According to one of the Abrils’ exhibits, Ms. Abril is suffering from and 
undergoing treatment for severe depression and posttraumatic stress disorder as a 
result of the laboratory’s negligence. 
 
 
2.  The complaint alleged that the department was liable for the laboratory’s 
negligence pursuant to section 768.28(10)(a), Florida Statutes (Supp. 1996), which 
states: 
 
3
 
Upon appeal of a trial court order dismissing the Abrils’ action, the Second 
District, in a unanimous decision explained in an opinion by Judge Canady, 
reversed the trial court, analogizing the case to that of Gracey v. Eaker, 837 So. 2d 
348 (Fla. 2002), in which this Court recently concluded that a civil action for 
damages arose from the breach by a psychotherapist of a statutory duty of 
confidentiality and privacy.  Abril, 884 So. 2d at 211-13.  As in Gracey, the district 
court found that a statute, in this case section 381.004(3)(f), Florida Statutes (Supp. 
1996), supported the recognition of a cause of action for negligence based upon the 
alleged breach of a duty of confidentiality on the part of the health care providers 
who conducted Ms. Abril’s HIV test.  Id. at 212.  Further, as in Gracey, the Second 
District concluded that the impact rule should not apply to bar such a claim even 
where no actual physical contact or injury was alleged.  Id. at 212-13.  We approve 
the district court’s decision reinstating the negligence cause of action.  
Analysis 
                                                                                                                                        
Health care providers or vendors, or any of their employees or agents, 
that have contractually agreed to act as agents of the Department of 
Corrections to provide health care services to inmates of the state 
correctional system shall be considered agents of the . . . Department  
. . . for the purposes of . . . section [768.28, Florida’s sovereign 
immunity waiver statute], while acting within the scope of and 
pursuant to guidelines established in said contract or by rule. 
 
The Second District noted that the department made no argument disputing its 
responsibility under this statute, and it has raised no such argument in this appeal.  
Abril, 884 So. 2d at 212 n. 3. 
 
4
This Court and other appellate courts review decisions resolving motions to 
dismiss under a de novo standard where those motions are based on a claim that no 
legal cause of action exists as alleged in the complaint.  Siegle v. Progressive 
Consumers Ins. Co., 819 So. 2d 732, 734 (Fla. 2002).  Here, the amended 
complaint alleges an action based on the negligence of Continental Laboratories, 
charging the department with vicarious liability for this negligence under the 
agency provisions of section 768.28(10)(a), pursuant to which the State has waived 
immunity for the actions of health care services provided by private persons at the 
request of the department.  See Abril, 884 So. 2d at 207-08.  
In their amended complaint, the Abrils alleged that Continental was 
negligent and that it “breached its professional duty [to Ms. Abril] by failing to 
provide that level of care, skill and treatment which, in light of all relevant 
surrounding circumstances is recognized as acceptable and appropriate by 
reasonably prudent similar health care providers.”  Because of this breach, the 
Abrils allege they suffered mental anguish and emotional distress.  Id.  In arguing 
for reconsideration after the trial court granted the department’s motion to dismiss, 
the Abrils argued that their action was one for medical malpractice because of 
Continental’s negligence resulting in breach of its duty to maintain the 
confidentiality of the test results.  Thus, the Abrils essentially asserted a common 
 
5
law negligence claim against Continental utilizing the breach of the provisions of 
section 381.004(3)(f) as evidence of Continental’s negligence.   
DUTY 
To maintain an action for negligence, a plaintiff must establish that the 
defendant owed a duty, that the defendant breached that duty, and that this breach 
caused the plaintiff damages.  See Clampitt v. D.J. Spencer Sales, 786 So. 2d 570, 
573 (Fla. 2001).  This Court has held that while breach, causation, and damages are 
ordinarily questions for the jury, “duty exists as a matter of law and is not a factual 
question for the jury to decide.”  McCain v. Fla. Power Corp., 593 So. 2d 500, 503 
(Fla. 1992).  It is the existence of a duty on the part of Continental that is at issue in 
this case.   
Section 381.004(3)(f) 
The district court relied primarily upon the provisions of section 
381.004(3)(f) as the source of a duty of confidentiality owed by Continental to Ms. 
Abril.  Section 381.004(3)(f) provides: 
Except as provided in this section, the identity of any person upon 
whom a[n HIV] test has been performed and test results are 
confidential and exempt from the provisions of s. 119.07(1).  No 
person who has obtained or has knowledge of a test result pursuant to 
this section may disclose or be compelled to disclose the identity of 
any person upon whom a test is performed, or the results of such a test 
in a manner which permits identification of the subject of the test . . . .  
 
 
6
In rejecting the department’s argument that no duty to Ms. Abril existed, the 
district court explained: 
 
The complaint filed by the Abrils alleges facts that would be 
sufficient to establish that Continental Laboratory violated a duty 
imposed on it by section 381.004 to maintain the confidentiality of 
HIV test results and to disclose those results only as authorized by 
law.  The issue presented for resolution thus is not whether the 
complaint’s allegations are sufficient to establish the necessary 
elements of the existence of a duty and the breach of that duty.  The 
dispositive question is whether the damages alleged––for mental 
anguish and emotional distress caused by Continental Laboratory’s 
breach of its duty––are cognizable under Florida law.  The answer to 
this question depends on whether the impact rule is applicable to the 
claims at issue. 
 
Abril, 884 So. 2d at 209-10.  Although the district court did not elaborate in great 
detail on its analysis, we conclude that the court was correct in its conclusion that 
the Abrils had properly alleged a cause of action for negligence.   
The courts of Florida have long recognized that the violation of a statute 
may be utilized as evidence of negligence.  In Alford v. Meyer, 201 So. 2d 489 
(Fla. 1st DCA 1967), the court explained:  
The rationale supporting the admission of a statute, ordinance, or 
administrative rule or regulation as prima facie evidence of negligence 
is that the standard of conduct or care embraced within such 
legislative or quasi-legislative measures represent a standard of at 
least reasonable care which should be adhered to in the performance 
of any given activity. 
Id. at 491; see also deJesus v. Seaboard Coast Line R. R. Co., 281 So. 2d 198 (Fla. 
1973).  Section 381.004(3)(f), at a minimum, creates a reasonable standard of care 
 
7
for handling HIV testing results, and Continental’s breach of this statute by the 
improper release of Abril’s results may be evidence that the laboratory acted 
negligently.  
 
The district court also noted that in addition to the explicit provisions for 
confidentiality of HIV testing under section 381.004, health care laboratories are 
also governed by other provisions of the Florida Statutes, such as the Florida 
Clinical Laboratory Law in section 483.181(2), Florida Statutes (1995), which 
explicitly mandates that “[t]he results of a test must be reported directly to the 
licensed practitioner or other authorized person who requested it.”  Abril, 884 So. 
2d at 209 n.1 (quoting section 483.181(2)).  Indeed, Florida has a long tradition of 
recognizing the privacy interests of patients in confidential medical records.  See, 
e.g., State v. Johnson, 814 So. 2d 390, 393 (Fla. 2002) ("A patient's medical 
records enjoy a confidential status by virtue of the right to privacy contained in the 
Florida Constitution, and any attempt on the part of the government to obtain such 
records must first meet constitutional muster.").  In addition to the specific 
provisions of section 381.004 protecting HIV testing, section 395.3025 of the 
Florida Statutes also expressly provides that a patient’s medical records are 
confidential and must not be disclosed without the consent of the patient.  Thus, it 
is apparent that more than one Florida statute may have been breached by the 
disclosure of Ms. Abril’s confidential medical information.   
 
8
 
Further, as is evidenced by our decision in Johnson, this Court has 
consistently and rigorously enforced the rights of patients to confidentiality in their 
medical records.  In view of these multiple sources of a duty of confidentiality and 
privacy, it is not surprising that the Second District declared that “the existence of 
a duty on the part of Continental Laboratory to maintain the confidentiality of 
information relating to Mrs. Abril’s HIV test is unquestioned.”  Abril, 884 So 2d at 
213.3  Because the Abrils could rely on the violation of several Florida statutes, 
including section 381.004, as evidence of negligence, we find no error in the 
district court’s reinstatement of their civil action for negligence. 
IMPACT RULE 
As did the district court, we look to our decision in Gracey and reach a 
similar result as to the application of the impact rule.  The impact rule, as applied 
in Florida, requires that “before a plaintiff can recover damages for emotional 
distress caused by the negligence of another, the emotional distress suffered must 
flow from physical injuries the plaintiff sustained in an impact.”  R.J. v. Humana 
of Fla., Inc., 652 So. 2d 360, 362 (Fla. 1995) (quoting Reynolds v. State Farm Mut. 
                                          
 
 
3.  As earlier noted, the Abrils broadly alleged that Continental breached its 
common law duty to act as a reasonably professional laboratory in like 
circumstances.  Abril, 884 So. 2d at 208.  In fact, although not directly pertinent to 
the legal issue before us, the Abrils presented affidavits in the trial court from 
various medical and research professionals, stating their opinion that the laboratory 
breached its professional duties in not properly disseminating the results of the 
HIV test results. 
 
9
Auto. Ins. Co., 611 So. 2d 1294, 1296 (Fla. 4th DCA 1992)).4  The rule actually 
requires some impact on the plaintiff, or, in certain situations, the manifestation of 
severe emotional distress such as physical injuries or illness.  Gracey, 837 So. 2d at 
355.  
Although this Court has upheld the viability of the impact rule, it has 
recognized exceptions where a plaintiff may recover for emotional damages even 
though he or she suffered no impact or physical manifestation of the injuries.  
These exceptions, however, “have been narrowly created and defined in a certain 
very narrow class of cases in which the foreseeability and gravity of the emotional 
injury involved, and lack of countervailing policy concerns, have surmounted the 
policy rationale undergirding the application of the impact rule.”  Rowell v. Holt, 
850 So. 2d 474, 478 (Fla. 2003).  For example, we have noted that the impact rule 
does not apply to any intentional torts, such as defamation, invasion of privacy, 
and intentional infliction of emotional distress.  Id. at 478 n.1.  The rule also 
appears not to apply to “freestanding torts” which exist regardless of what 
emotional damages may accompany these torts, such as wrongful birth.  See Kush 
v. Lloyd, 616 So. 2d 415, 422 (Fla. 1992). 
                                          
 
 
4.  Our decision in Humana involved a claim for misdiagnosis of HIV/AIDS, 
and did not involve a claim for breach of confidentiality or unlawful dissemination 
of confidential information. 
 
10
In Gracey, this Court also recognized an exception to the impact rule for a 
breach of the duty of confidentiality as to the release of sensitive personal 
information.  Gracey, 837 So. 2d at 357.  The Abrils assert that as with the breach 
of confidentiality in Gracey, the emotional damages resulting from the 
dissemination of confidential HIV test results are foreseeable and grave.   
In the instant case, the Second District held that the impact rule did not bar 
the emotional distress damages asserted in the claim below.  Abril, 884 So. 2d at 
213.  The court again analogized the case to Gracey, where this Court held that the 
impact rule should not apply because the emotional distress the Graceys suffered 
as a result of their psychotherapist breaching his duty of confidentiality, was 
at least equal to that typically suffered by the victim of a defamation 
or an invasion of privacy.  Indeed, we can envision few occurrences 
more likely to result in emotional distress than having one’s 
psychotherapist reveal without authorization or justification the most 
confidential details of one’s life.  Our reasoning in Kush thus provides 
ample support for the notion that the impact rule should be 
inapplicable to the instant case.  
 
Gracey, 837 So. 2d at 356.  In Gracey this Court also relied on the statutory duty it 
found as evidence that the Legislature recognized that plaintiffs could be injured 
by breaches of the duty of confidentiality, regardless of whether they suffered any 
physical impact or injury.  Id. at 357.  The Second District stated that this same 
reasoning applied in the instant case, and also relied on this Court’s opinion in 
Rowell, stating that “there is no legally significant distinction between the 
 
11
‘foreseeability and gravity of the emotional injury involved’ in the instant case and 
the ‘foreseeablity and gravity of the emotional injury’ involved in Gracey.”  Abril, 
884 So. 2d at 212.   
 
The district court noted that the statutes in Gracey and in the instant case had 
the same purpose of protecting individuals from disclosure of highly personal, 
sensitive information and in both situations, the only possible injury flowing from 
the violation of the respective statutes was emotional distress.  Abril, 884 So. 2d at 
212.  While the court noted that unlike Gracey, no technical fiduciary relationship 
existed between the laboratory and the plaintiffs, the duty of confidentiality owed 
to the plaintiffs was “unquestioned.”  Id. at 213. 
We agree with the district court that this Court’s analysis in Gracey sets 
strong precedential authority for this exception.  At least one clear purpose behind 
the enactment of section 381.004(3)(f) was to ensure that people potentially 
exposed to HIV would get tested.  The Legislature also apparently concluded, 
however, that people may resist HIV testing because of the fear that their results 
would become public knowledge.  § 381.004(1), Fla. Stat. (Supp. 1996).  The 
specific safeguards provided by the statute to prevent disclosure lend weight to the 
argument that public dissemination of the test results would cause emotional 
distress, and thus Continental should have known that by sending the results in an 
 
12
unsecured fax, it was risking causing great emotional distress to the Abrils if an 
unauthorized party saw the test results.   
Because the only reasonable damages arising from a breach of section 
381.004(3)(f) are emotional distress, and because this emotional damage would be 
akin to that suffered by victims of defamation or invasion of privacy, we conclude 
they should not be barred by the impact rule.  See Gracey, 837 So. 2d at 356-57 
(holding that the impact rule should not bar recovery because “[t]he emotional 
distress that [plaintiffs] allege they have suffered is at least equal to that typically 
suffered by the victim of a defamation or an invasion of privacy” and that 
“[i]mposition of the impact rule in this context would render the legislative intent 
and its statutory implementation meaningless and without substance”).  Thus, 
based on our recent precedent in Gracey we agree that an exception to the impact 
rule should be made when a laboratory or other health care provider is negligent in 
failing to keep confidential the results of an HIV test. 
Accordingly, we approve the Second District’s decision reversing the trial 
court’s dismissal of appellee’s action and we further approve the court’s holding 
that the impact rule does not bar a cause of action for a breach of confidentiality in 
negligently disclosing the results of HIV testing.  
It is so ordered. 
LEWIS, C.J., and ANSTEAD, PARIENTE, and QUINCE, JJ., concur. 
PARIENTE, J., concurs with an opinion. 
 
13
CANTERO, J., concurs in part and dissents in part with an opinion. 
WELLS, J., dissents with an opinion. 
BELL, J., dissents with an opinion, in which WELLS, J., concurs. 
 
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND 
IF FILED, DETERMINED. 
 
 
 
PARIENTE, J., concurring. 
 
I agree with the majority that where a laboratory or health care provider 
negligently fails to maintain the confidentiality of HIV test results, Florida’s 
impact rule does not preclude recovery of emotional distress damages.  Under 
these circumstances, emotional distress damages are likely the only possible 
injuries flowing from the negligent conduct.  Further, the “foreseeability and 
gravity of the emotional injury involved, and lack of countervailing policy 
concerns . . . surmount[] the policy rationale undergirding application of the impact 
rule.”  Rowell v. Holt, 850 So. 2d 474, 478 (Fla. 2003).   
 
I write separately to once again express my view that the impact rule as it 
exists in Florida is no longer a viable mechanism for limiting recoverable damages 
in cases involving torts and to urge this Court to consider abolishing the impact 
rule.  Although Justice Cantero and I might disagree as to the precise test that 
would replace the confusing and outdated impact rule, I agree with Justice Cantero 
that our case-by-case approach has done nothing to stabilize the law or to clarify 
when an exception will be recognized.  
 
14
 
As I have explained in previous decisions, I would adopt the traditional 
foreseeability analysis applicable to negligence claims as the more appropriate 
framework for a limitation on tort recovery in this state.  See, e.g., Willis v. Gami 
Golden Glades, LLC, No. SC04-1929, slip op. at 35 (Fla. Oct. 18, 2007) (Pariente, 
J., concurring); Rowell, 850 So. 2d at 484 (Pariente, J., specially concurring); 
Gracey v. Eaker, 837 So. 2d 348, 359 (Fla. 2002) (Pariente, J., concurring).  “As a 
practical matter, the traditional foreseeability analysis eliminates the arbitrary 
requirement of the impact rule, which will lead to greater stability and greater 
predictability in this area of the law.”  Willis, slip op. at 35 (Pariente, J., 
concurring).  This analysis will also provide guidance to the lower courts in this 
state and end the need for district courts to certify questions to this Court resulting 
from the lack of predictability as to when an exception to the impact rule will be 
created.  
 
CANTERO, J., concurring in part and dissenting in part. 
 
 
I agree that a violation of the confidentiality requirement in the HIV testing 
statute––section 381.004(3)(f), Florida Statutes (Supp. 1996)––may be used as 
evidence of negligence.  Such a result is consistent with a long line of cases dating 
back to deJesus v. Seaboard Coast Line Railroad Co., 281 So. 2d 198 (Fla. 1973).  
We did create some tension with deJesus by holding, in Murthy v. N. Sinha Corp., 
 
15
644 So. 2d 983 (Fla. 1994), that legislative intent “should be the primary factor . . . 
in determining whether a cause of action exists when a statute does not expressly 
provide for one.”  Id. at 985.  Therefore, if we were to assign so much weight to a 
statutory violation that we essentially created a private cause of action, without any 
legislative intent to do so, we would violate Murthy’s principles.  But we can 
reconcile deJesus and Murthy by relegating statutes to a lesser role in negligence 
cases.  Even when a statutory violation provides some evidence of negligence, 
other proof of the defendant’s level of care also will have to be considered.  
Moreover, the factfinder will have to evaluate other issues such as proximate cause 
and comparative negligence.  These hurdles should prevent statutory evidence of 
negligence from becoming a statutory cause of action in disguise.   
Consider, for example, a motorist involved in an accident while traveling 
thirty-five miles per hour in a thirty miles-per-hour speed zone.  An injured 
plaintiff could use the violation of the posted speed limit as evidence of the 
driver’s negligence, but the speeding alone would not conclusively establish breach 
of duty in the manner of negligence per se.  Under an evidence of negligence 
standard, the injured plaintiff would still have to prove all the elements of 
negligence: duty, breach, causation, and damages.  The driver’s speeding could be 
used as one item of evidence, along with others, of negligent driving.   See deJesus, 
281 So. 2d at 201 (“Proof of violation of a traffic ordinance is prima facie evidence 
 
16
only of ‘negligence’; proximate cause and other elements of actionable negligence 
must be proven independently.”).  
The Fourth District Court of Appeal applied this reasoning in Chevron 
U.S.A., Inc. v. Forbes, 783 So. 2d 1215 (Fla. 4th DCA 2001).  In Chevron, the 
plaintiff slipped and fell when he stepped into a puddle at a gas station.  The trial 
court instructed the jury that it could find the gas station negligent per se for 
violating section 526.141, Florida Statutes (1997), which governs the general 
operation of self-service gas stations.  The district court reversed, holding that 
“under deJesus, violation of section 526.141 [was] merely evidence of negligence, 
rather than negligence per se.”  Id. at 1219.  See also Lindsay v. Bill Arflin 
Bonding Agency, Inc., 645 So. 2d 565 (Fla. 1st DCA 1994) (relying on deJesus to 
hold that violation of a handrails ordinance could only be used as evidence of 
negligence and not as negligence per se).  These cases demonstrate the distinction 
between treating a statutory violation as evidence of negligence and treating it as 
negligence per se. 
Because the majority suggests only a limited role for the HIV testing statute 
in negligence cases, I join that part of its analysis.  I disagree with the majority, 
however, to the extent it creates yet another in a line of ad hoc, fact-specific 
exceptions to the impact rule.  The rule, which dates back even further than 
deJesus, to at least International Ocean Telegraph Co. v. Saunders, 14 So. 148 (Fla. 
 
17
1893), bars recovery of damages for emotional distress unless the distress flows 
from physical injuries sustained in an impact, or at least produces physical injuries 
itself.  See, e.g., Rowell v. Holt, 850 So. 2d 474, 477-78 (Fla. 2003).  In this case, 
it is undisputed that the plaintiffs have suffered no physical injuries.  We already 
have refused to create an exception to the impact rule for a claim of negligent 
misdiagnosis of HIV.  See R.J. v. Humana of Fla., Inc., 652 So. 2d 360, 362 (Fla. 
1995).  By allowing recovery of emotional distress damages for disclosure of an 
HIV diagnosis, but not for the arguably more distressing misdiagnosis, the majority 
further complicates an already unpredictable and confusing jurisprudence. 
 
As I explain in my dissent in Willis v. Gami Golden Glades, L.L.C., 
No. SC04-1929, slip op. at 46 (Fla. Oct. 18, 2007) (Cantero, J. dissenting), we 
traditionally have held that plaintiffs seeking to recover for emotional distress in a 
negligence action must demonstrate that they suffered a physical injury sustained 
in an impact.  This requirement is known as the impact rule.  We have gradually 
refined the rule to where the physical injury need not result from the impact, but 
can now also result from the emotional distress itself.  See, e.g., Champion v. Gray, 
478 So. 2d 17, 18 (Fla. 1985).  In Willis, however, this Court further relaxed the 
rule to allow recovery for mere impact, without any physical injury at all.  See 
Willis, slip op. at 6-8.  As revised, the rule has been rendered useless, hinging 
recovery on arbitrary factors unrelated to a claim’s authenticity.  For example, in 
 
18
Willis, recovery depended on whether the gun that an armed robber pointed at the 
victim’s head actually touched her.  Thankfully, we need not ask such arbitrary 
questions here because the plaintiffs have not even alleged an impact.  Even under 
Willis’s generous formulation, therefore, they cannot satisfy the impact rule. 
 
The majority nevertheless allows recovery for emotional distress because it 
concludes that the impact rule does not apply to a laboratory’s (or other health-care 
provider’s) negligent disclosure of confidential HIV test results.  Majority op. at 
13.  The majority thus creates another ad-hoc exception to the impact rule to cover 
the specific facts of this case. 
 
Of course, this is hardly the first time we have created a fact-specific 
exception to the rule.  As I noted in Willis, we have essentially created exceptions 
whenever we felt that applying the rule would be unjust.  See, e.g., Rowell, 850 So. 
2d at 474 (creating an exception for legal malpractice that needlessly extends a 
client’s imprisonment); Gracey v. Eaker, 837 So. 2d 348 (Fla. 2002) (creating an 
exception for negligent breach of confidentiality by a psychotherapist); Hagan v. 
Coca-Cola Bottling Co., 804 So. 2d 1234 (Fla. 2001) (creating an exception for 
ingestion of a contaminated food or beverage); Tanner v. Hartog, 696 So. 2d 705 
(Fla. 1997) (creating an exception for negligent stillbirth); Gonzalez v. Metro. 
Dade County Pub. Health Trust, 651 So. 2d 673 (Fla. 1995) (creating an exception 
for negligent handling of a corpse); Kush v. Lloyd, 616 So. 2d 415 (Fla. 1992) 
 
19
(creating an exception for negligent failure to diagnose an inheritable genetic 
impairment).  Discerning the logical relationship among these exceptions is a 
challenge.  Constructing a predictable jurisprudence from them is impossible. 
 
Today the majority extends the exception we created when a psychotherapist 
breached a duty of confidentiality, citing that case as “strong precedential 
authority” for creating another exception when a laboratory negligently discloses 
confidential HIV test results.  Majority op. at 12.  But the two situations are easily 
distinguished.  In Gracey, 837 So. 2d at 348, a psychotherapist allegedly breached 
his fiduciary duty to his patients by disclosing confidential information about them.  
We concluded that “the nature of the fiduciary relationship in the psychotherapist-
patient and physician-patient contexts and the attendant duty of confidentiality 
imposed on the practitioner, along with the intent of the Legislature” in demanding 
confidentiality, served as “ample authority to determine that the impact rule should 
be inapplicable.”  Id. at 357.  By contrast, the plaintiffs in this case did not allege a 
fiduciary relationship with the laboratory.  They only alleged common-law 
negligence.   
The majority dismisses this distinction, emphasizing that both Gracey and 
this case involved an alleged “disclosure of highly personal, sensitive information” 
in violation of a statute.  Majority op. at 12.  That may be true, but in Gracey we 
did not hold, and the decision did not even imply, that we were establishing a 
 
20
broad exception to the impact rule for any disclosure of statutorily protected 
information.  The exception was expressly limited to “cases in which a 
psychotherapist has created a fiduciary relationship and has breached a statutory 
duty to his or her patient.”  Gracey, 837 So. 2d at 357.  Not only did we identify 
the fiduciary relationship as essential, we also cautioned that the exception would 
be confined to “the particular facts of the case before us” and “should not be 
construed as bringing into question the continued viability of the impact rule in 
other situations.”  Id. at 358.  Today’s decision contradicts Gracey while claiming 
to apply it. 
 
The majority also analogizes the distress caused by the disclosure of HIV 
test results “to that suffered by victims of defamation or invasion of privacy,” 
majority op. at 13, for whom recovery of emotional distress damages is allowed.  
But defamation and invasion of privacy are intentional torts.  As we recently 
explained, “the impact rule is inapplicable to recognized intentional torts that result 
in predominantly emotional damages such as intentional infliction of emotional 
distress, defamation, or invasion of privacy claims.”  So. Baptist Hosp. of Fla., Inc. 
v. Welker, 908 So. 2d 317, 320 (Fla. 2005).  In this case, the plaintiffs do not 
allege an intentional tort.  If the majority means to imply that any negligence claim 
resulting in predominantly emotional damages of the sort seen in defamation and 
invasion of privacy claims (e.g., public humiliation, feelings of intrusion) is now 
 
21
exempted from the impact rule, then the exceptions have truly swallowed the rule.  
Almost any negligent act can be portrayed as humiliating or intrusive.  If, on the 
other hand, the majority means to imply that the amount of emotional distress must 
be equal to that caused by defamation and invasion of privacy, the majority offers 
no scale for measuring levels of emotional distress.  The intentional torts of 
defamation and invasion of privacy range in severity across a wide spectrum—just 
as negligence claims do.  Again, the rule will essentially disappear. 
 
While drawing these tenuous analogies to some of our less relevant 
precedents, the majority essentially ignores the case most on point––Humana, 652 
So. 2d at 362.  There, we refused to create an exception to the impact rule for the 
negligent misdiagnosis of HIV.  We reasoned that “it would be exceedingly 
difficult to limit speculative claims for damages in litigation under such an 
exception.”  Id. at 364.  In this case, the plaintiffs also allege an HIV misdiagnosis.  
They further allege that the test results were negligently disclosed to third parties.  
Yet rather than follow Humana and apply the impact rule, the majority establishes 
a new exception for the negligent disclosure of HIV test results.  As a result, 
plaintiffs may now recover emotional distress damages for the disclosure of 
negative test results but not for a misdiagnosis of HIV-positive results.  This 
upside-down jurisprudence defies the purpose of the impact rule, which is to limit 
recovery to those cases where we are most confident that real emotional distress 
 
22
has occurred.  We have no reason to believe that telling an unauthorized third party 
about a person’s HIV test results (which may be negative) is more likely to cause 
emotional distress than misinforming a patient that she is infected with HIV.  The 
opposite is more likely true.  The impact rule was designed to avoid such 
speculation. 
I admit the impact rule is imperfect.  Its underlying assumption––that those 
who sustain physical injuries are more likely to suffer serious emotional distress 
than those who do not––offers consistency at the price of flexibility, which means 
that sometimes its application to a specific case may seem unjust.  Moreover, the 
rule has confused the lower courts, producing a steady stream of certified questions 
for this Court to answer.  Because of these problems, I remain willing to scrap the 
rule and replace it with a more workable analysis, as I recommend in Willis.  See 
Willis, slip op. at 67-68 (Cantero, J., dissenting).  But chipping away at the rule 
with yet another fact-specific exception––especially in a case so similar to one in 
which we refused to create one––will only add to the exceptions’ arbitrariness, 
create more confusion about when the rule applies, and generate more certified 
questions—which, if our recent decisions are any indication, will lead to even 
more exceptions.  Until we replace the current rule with one more equitable and 
predictable, we should apply the one we have and stop creating exceptions at every 
 
23
turn.  To the extent the majority refuses to apply the rule here, I respectfully 
dissent. 
 
WELLS, J., dissenting. 
 
I dissent from the majority’s decision because I cannot see how this 
negligence case, involving results from an HIV test, materially differs from R.J. v. 
Humana of Florida, Inc., 652 So. 2d 360 (Fla. 1995), which involved negligence in 
respect to an HIV test.  In R.J. v. Humana, the majority of this Court held that the 
impact rule barred recovery, whereas the present majority holds that the impact 
rule does not bar recovery. 
 
I find the majority’s opinion to be particularly inconsistent in view of the 
present majority’s reliance on Gracey v. Eaker, 837 So. 2d 348 (Fla. 2002), for the 
present holding, in view of the following from the Gracey opinion at 358: 
 
On the other hand, our holding should not be construed as 
bringing into question the continued viability of the impact rule in 
other situations.  Six years ago, this Court stated its belief in the 
overall efficacy of the impact rule: 
We reaffirm . . . our conclusion that the impact rule 
continues to serve its purpose of assuring the validity of 
claims for emotional or psychic damages, and find that 
the impact rule should remain part of the law of this state. 
R.J. v. Humana of Florida, Inc., 652 So. 2d at 363.  Today we simply 
hold that the impact rule is inapplicable under the particular facts of 
the case before us. 
 
 
 
24
BELL, J., dissenting.  
If it were appropriate to answer the question as certified, I would agree with 
Justices Wells and Cantero that the impact rule bars the Abrils from recovering 
damages for emotional distress and that we should resist creating another 
exception.  However, because the Abrils do not rely upon the duty of 
confidentiality created by section 381.004(3)(f), the certified question has no basis 
in the record and, therefore, should be revised.  Furthermore, the majority opinion 
fails to confine its answer to the medical malpractice action brought by the Abrils.  
Regardless, because the majority has chosen to answer the question as certified, I 
must discuss a more fundamental concern I have that is not addressed by the other 
dissenting opinions.   
I am concerned that the majority’s opinion leaves the impression that after 
Gracey v. Eaker, 837 So. 2d 348 (Fla. 2002), and this case, the law in Florida is 
that a breach of any clear statutory duty will give rise to tort liability irrespective of 
the remedies chosen by the Legislature to address any such breach.  Moreover, I 
am concerned that in answering the certified question and approving the decision 
below, the majority does not simply approve the use of an existing tort action, but 
it approves the use of a new common law tort.5  Modifying or abrogating the 
                                          
 
5.  Unlike Justice Cantero, I am unable to accept the majority’s 
characterization of its holding as establishing that a violation of section 381.004 is 
merely “evidence of negligence” in an ordinary negligence case.  Instead, I read 
 
25
common law to allow a new tort based on the breach of a statutorily created duty 
(not to mention creating another exception to the impact rule) is a very significant 
policy decision.  And that the majority would do so without any meaningful 
consideration of legislative intent and purpose is contrary to our precedent and the 
limited role the judiciary is supposed to play in our form of government.   
I will elaborate below on each of these concerns.  In the first part (I), I 
discuss my concerns regarding the propriety of answering the question as certified 
as well as the majority’s failure to limit its answer to the medical malpractice 
context.  In the second part (II), I discuss my concerns that the majority is 
modifying the common law in order to provide a private remedy that would not 
otherwise exist and that it is doing so without any meaningful examination of 
legislative intent.  At the end of this discussion, I distinguish Gracey.  
I. 
A. The Certified Question Should Be Revised 
                                                                                                                                        
the majority’s opinion as replacing the reasonable person standard with the specific 
statutory duty not to disclose HIV testing results under section 381.004.  The 
majority opinion expressly states that “[s]ection 381.004(3)(f), at a minimum, 
creates a reasonable standard of care for handling HIV testing results.”  Majority 
op. at 7-8.  And, when a court replaces the reasonable person standard with a 
specific statutory duty, the result is negligence per se.  See generally Restatement 
(Second) of Torts § 288B (1965) (discussing effect of violation of statute in 
common law negligence actions and distinguishing “negligence per se” from 
“evidence of negligence”); Prosser and Keeton on the Law of Torts § 36 (W. Page 
Keeton, et al. eds., 5th ed. 1984) (same). 
 
 
26
The certified question is not supported by the record and, therefore, should 
be revised.  The certified question asks whether Florida’s impact rule applies “in a 
case in which it is alleged that the infliction of emotional injuries has resulted from 
a clinical laboratory’s breach of a duty of confidentiality under section 
381.004(3)(f).”  Abril v. Dep’t of Corr., 884 So. 2d 206, 213 (Fla. 2d DCA 2004).  
No such case is before this Court.  The Abrils have repeatedly disclaimed any 
reliance upon the duty of confidentiality created by section 381.004(3)(f).  As 
stated in their brief to us: 
For the reasons stated in this Brief, Respondents do not believe this 
case concerns this certified question, because Respondents do not rely 
on Section 381.004 at all in their Amended Complaint. . . . 
 
. . . .  
 
Respondents’ cause of action for medical malpractice relies 
upon expert witnesses who will testify, as they have indicated in their 
reports, that Continental violated prevailing standards of practice 
when its employees negligently disclosed results of confidential blood 
test results to persons not authorized to receive those results. 
 
Respondents will not rely upon Section 381.004 to prove 
breach of standards.  Respondents will rely upon the testimony of a 
medical expert (pathologist with clinical laboratory experience) who 
will testify concerning the breach of prevailing professional standards.  
Amended Respondents’ Answer Br. at 3-4 & n.2 (emphasis added). 
 
 The record confirms the Abrils’ position.  Their amended complaint never 
mentions or relies upon section 381.004.6  It simply alleges that the laboratory 
                                          
 
6.  In footnote 3 of their Amended Answer Brief, the Abrils explain that 
“[t]he initial Complaint alleged a violation of Section 381.004.  The First Amended 
Complaint alleges a violation of prevailing professional standards.  The only 
 
27
“breached its professional duty . . . in that it revealed the contents of Abril’s HIV 
test results to persons not authorized to receive the information.”  In this light, the 
majority’s statement that “the Abrils essentially asserted a common law negligence 
claim against Continental utilizing the breach of the provisions of section 
381.004(3)(f) as evidence of Continental’s negligence” has no basis in the record.  
Majority op. at 5-6.  Consequently, because this case is clearly not “a case in which 
it is alleged that [the injury] has resulted from a . . . breach of a duty of 
confidentiality under section 381.004(3)(f),” majority op. at 2, the certified 
question should be revised.  
B.  The Abrils’ Claim Is for Medical Malpractice 
 My concern about this Court’s answering the question as certified is 
amplified by the breadth of the majority’s opinion.  The majority fails to confine its 
decision to the medical malpractice context.  As noted in the above quote from the 
Abrils’ brief, their claim is one for medical malpractice, a very specialized form of 
tort action.  The Abrils’ counsel reiterated this point at oral argument.  He said, 
“Kush v. Lloyd is the case I am primarily relying upon, medical malpractice.”  
Kush v. Lloyd, 616 So. 2d 415 (Fla. 1992). 7  Not only does the majority opinion 
                                                                                                                                        
reference to Section 381.004 violations are in some of the expert witness opinions 
which will not be relied upon in Respondents’ cause of action.” 
 
7.  In Kush, this Court addressed the following certified question of great 
importance in a medical malpractice case:  “In a case involving negligent failure to 
diagnose an inheritable genetic impairment, is the resulting cause of action for 
 
28
ignore the fact that the Abrils adamantly disclaim any reliance upon section 
381.004, it also essentially ignores the fact that this question arose in the context of 
a medical malpractice action.  In doing so, the majority never discusses Kush, the 
primary case upon which the Abrils say they rely. 
II. 
Having challenged both the appropriateness of answering the question as 
certified as well as the majority’s failure to answer the question in the context of 
the cause of action as pled, I now address my substantive concerns about the 
majority’s opinion.  To reiterate, I am concerned that, in approving the decision 
below, the majority seemingly concludes that a breach of any clear statutory duty 
creates potential tort liability irrespective of the remedies expressly provided by the 
Legislature.  Moreover, in doing so, the majority recognizes a new common law 
action for nonintentional, negligent breaches of the duty of confidentiality in 
section 381.004(3)(f).  And, most importantly, it does so without any meaningful 
consideration as to whether modifying or abrogating the common law to add this 
new tort remedy is consistent with legislative intent.  Certainly, this Court has the 
discretion to provide such a remedy, but as the Restatement (Second) of Torts 
cautions, this Court “must be careful to exercise that discretion cautiously and 
                                                                                                                                        
wrongful birth extinguished by the four-year statute of repose if the genetically 
impaired child is born more than four years after the negligent diagnosis?”  Id. at 
415. 
 
29
soundly.”  Restatement (Second) of Torts § 874A cmt. d (1979).  Respectfully, 
given the complete absence of any meaningful consideration of legislative intent, I 
do not find the majority’s exercise of this Court’s discretion to be either cautious or 
sound. 
In support of my position, I first establish that the majority opinion 
seemingly approves the Second District’s conclusion that a breach of any clear 
statutory duty may give rise to tort liability.  Then, I explain why this Court should 
apply a legislative intent analysis and why this analysis requires that the district 
court’s opinion be quashed.  Finally, I discuss why Gracey is distinguishable and 
should not be extended to an action in simple negligence. 
A.  The Majority’s Approval of Breach of Statutory Duty Necessarily Giving 
Rise to Civil Liability 
 
By answering the question as certified, approving the decision below, and 
concluding that the district court “was correct in its conclusion,” the majority’s 
opinion leaves the impression that this Court is validating the Second District’s 
interpretation of this Court’s precedent.  Majority op. at 7.  Relying primarily on 
Gracey, the Second District determined that a breach of the duty of care imposed 
by section 381.004(3)(f) gives rise to tort liability.  It concluded that “[w]hen a 
statute creates a clear duty of care, the violation of that duty can ‘generate[ ] a 
viable cause of action in tort.’ ”  Abril, 884 So. 2d at 209 (quoting Gracey, 837 So. 
2d at 353, and citing deJesus v. Seaboard Coast Line R.R. Co., 281 So. 2d 198 
 
30
(Fla. 1973), as well as Lewis v. City of Miami, 173 So. 150 (Fla. 1937)).  The 
Second District reached this conclusion without any examination of legislative 
intent, particularly the efficacy of the express statutory remedies. 8   The effect of 
that decision was to add a new tort remedy to the administrative and criminal 
remedies the Legislature provided for breaches of the duty in section 381.004(3)(f).  
The majority applies the same basic analysis.  Indeed, in answering the question as 
certified, the majority seems to agree with the Second District that, irrespective of 
legislative intent, the law in Florida after Gracey is that “[w]hen a statute creates a 
clear duty of care, the violation of that duty can ‘generate[ ] a viable cause of 
action in tort.’ ”  Id.9   
                                          
 
 
8.  Specifically, the Second District stated: 
 
 
The complaint filed by the Abrils alleges facts that would be 
sufficient to establish that Continental Laboratory violated a duty 
imposed on it by section 381.004 to maintain the confidentiality of 
HIV test results and to disclose those results only as authorized by 
law.  The issue presented for resolution thus is not whether the 
complaint's allegations are sufficient to establish the necessary 
elements of the existence of a duty and the breach of that duty.  The 
dispositive question is whether the damages alleged––for mental 
anguish and emotional distress caused by Continental Laboratory’s 
breach of its duty––are cognizable under Florida law.  The answer to 
this question depends on whether the impact rule is applicable to the 
claims at issue.  
Abril, 884 So. 2d at 209-10. 
 
9.  This same reasoning led Sir Edward Coke in 1642 to remark that “[e]very 
Act of Parliament made against any injury, mischiefe, or grievance doth either 
 
31
The majority’s apparent agreement with the Second District’s outdated 
analysis is exacerbated by the breadth of its holding.  The majority holds “that an 
entity that negligently and unlawfully violates a patient’s right of confidentiality 
and privacy in disclosing the results of HIV testing of the patient may be held 
responsible in a civil negligence action for damages caused to the patient by the 
unlawful disclosure.”  Majority op. at 2.  This holding represents a significant 
change in Florida tort law.  Previously, a cause of action for breach of 
confidentiality or invasion of privacy had been limited to the province of 
intentional torts.  See, e.g., S. Baptist Hosp. of Fla., Inc. v. Welker, 908 So. 2d 317, 
320 (Fla. 2005) (categorizing invasion of privacy claims as within the gamut of 
intentional torts); Rowell v. Holt, 850 So. 2d 474, 478 n.1 (Fla. 2003) (same).  By 
approving a cause of action for a nonintentional, negligent breach of a duty of 
confidentiality, the majority expands breach of confidentiality or invasion of 
privacy actions to the much broader realm of general negligence.  In doing so, the 
majority recedes from this Court’s prior decisions sub silentio.  Simply stated, the 
majority’s broad holding effectively modifies or abrogates the common law by 
                                                                                                                                        
expressly, or impliedly give a remedy to the party wronged or grieved [by any 
violation of Act].”  H. Miles Foy, III, Some Reflections on Legislation, 
Adjudication, and Implied Private Actions in the State and Federal Courts, 71 
Cornell L. Rev. 501, 524 (1986) (quoting Edward Coke, Second Part of the 
Institutes of the Laws of England 55 (1642)).  Coke’s reasoning was rejected by 
the judiciary in this country beginning in the middle of the nineteenth century.  Id.  
 
32
recognizing a new common law cause of action for the negligent breach of the duty 
of confidentiality created by section 381.004(3)(f).    
B.  Consistency with Legislative Intent Is Necessary 
 
Adding to the legislatively prescribed remedies for breaches of a statutory 
duty by creating a new common law remedy without any meaningful examination 
of legislative intent is contrary to the judiciary’s proper function in our form of 
government.  It is contrary to the principle this Court recognized over twenty-five 
years ago, when it said: 
As a general rule, that part of the common law codified by section 
2.01 should be changed through legislative enactment and not by 
judicial decision.  Only in very few instances and with great hesitation 
has this Court modified or abrogated any part of the common law 
enacted by section 2.01, and then only where there was a compelling 
need for change and the reason for the law no longer existed.  E.g., 
Hoffman v. Jones, 280 So. 2d 431 (Fla. 1973). 
Raisen v. Raisen, 379 So. 2d 352, 353-54 (Fla. 1979).  Similarly, it is contrary to 
the principle recognized in Murthy v. N. Sinha Corp., 644 So. 2d 983, 985 (Fla. 
1994), where this Court unanimously agreed that “legislative intent . . . should be 
the primary factor considered by a court in determining whether a cause of action 
exists when a statute does not expressly provide for one.” (Emphasis added.)  It is 
also contrary to the evolution in tort law that has been recognized by the 
Restatement (Second) of Torts since 1979, when the authors adopted section 874A 
(Tort Liability for Violation of Legislative Provision) to supplement the approach 
 
33
previously suggested by section 286 of the Restatement (Second) of Torts (1965).  
See Restatement (Second) of Torts § 874A cmt. d (1979) (“If the court has reached 
the conclusion that the legislative body did actually have the intent either to 
establish a civil remedy to protect and enforce the right or to limit the relief to that 
expressly provided for in the legislative provision, the issue is settled, and the court 
is warranted in declaring that it is complying with the legislative intent.”).   
 
Raisen, Murthy, and section 874A of the Restatement recognized a 
fundamental, general principle:  (1) if the Legislature expressly provides remedies 
for the breach of a new duty it imposes (and a private remedy is not included 
among these remedies), and (2) there is no indication that the Legislature intends to 
change the common law by providing a private remedy for a breach of that duty, 
the courts should not modify the common law in order to create a remedy.  In other 
words, except in very unique cases, the courts should accept the Legislature’s 
express choice of remedies for the breach of a duty it created and not modify the 
common law to create an additional remedy. 
As stated earlier, while the courts certainly have the discretion to add a 
private remedy to the remedies provided by the Legislature, they “must be careful 
to exercise that discretion cautiously and soundly.”  Restatement (Second) of Torts 
§ 874A cmt. d (1979).  It must be exercised cautiously in order to preserve the 
 
34
important boundary between judicial and legislative powers.10  And the thorough 
examination of legislative intent ensures that the court exercises its judicial powers 
cautiously and soundly.   
Section 874A of the Restatement (Second) of Torts suggests a meaningful 
method for thoroughly examining legislative intent.  Under this method, the court 
initially considers whether the Legislature intended to create a private civil remedy 
or to modify the common law in order to provide a private remedy in tort.  
                                          
 
10.  As then Professor Easterbrook explained, the “judicial pursuit of the 
‘values’ or aims of legislation is a sure way of defeating the original legislative 
plan”: 
 
A legislature that seeks to achieve Goal X can do so in one of two 
ways.  First, it can identify the goal and instruct courts or agencies to 
design rules to achieve the goal.  In that event, the subsequent 
selection of rules implements the actual legislative decision, even if 
the rules are not what the legislature would have selected itself. The 
second approach is for the legislature to pick the rules.  It pursues 
Goal X by Rule Y.  The selection of Y is a measure of what Goal X 
was worth to the legislature, of how best to achieve X, and of where to 
stop in pursuit of X.  Like any other rule, Y is bound to be imprecise, 
to be over- and under-inclusive.  This is not a good reason for a court, 
observing the inevitable imprecision, to add to or subtract from Rule 
Y on the argument that, by doing so, it can get more of Goal X.  The 
judicial selection of means to pursue X displaces and directly 
overrides the legislative selection of ways to obtain X.  It denies to 
legislatures the choice of creating or withholding gapfilling authority. 
The way to preserve the initial choice is for judges to put the statute 
down once it becomes clear that the legislature has selected rules as 
well as identified goals. 
Frank H. Easterbrook, Statutes’ Domains, 50 U. Chi. L. Rev. 533, 546-47 (1983) 
(footnotes omitted).     
 
35
Restatement (Second) of Torts § 874A cmt. c (1979).  If the court finds the 
legislature never contemplated the issue of a private civil remedy, “the primary test 
for determining whether the courts should provide a tort remedy for violation of 
the legislative provision is whether this remedy is consistent with the legislative 
provision, appropriate for promoting its policy and needed to assure its 
effectiveness.”  Restatement (Second) of Torts § 874A cmt. h (1979).  Using this 
Restatement method of examining legislative intent, I will establish that there is no 
basis to add to the remedies the Legislature expressly provided for when it 
developed Florida’s strategy to confront the HIV/AIDS public health crisis and, as 
part of that strategy, created the duty of confidentiality for HIV testing. 
C.  Legislative Intent of Section 381.004 
The language of section 381.004 does not manifest any intent to create a 
private claim in negligence.  See DeGregorio v. Balkwill, 853 So. 2d 371, 373 
(Fla. 2003) (“Legislative intent is determined primarily from the statute’s 
language.”) (citing Hayes v. State, 750 So. 2d 1, 3 (Fla. 1999)).  If the duty of 
confidentiality created in section 381.004(3)(f) is breached, the individual offender 
is to be sanctioned administratively or punished criminally as provided by section 
381.004(6).  Section 381.004(6) provides: 
 
(6) PENALTIES.— 
 
(a) Any violation of this section by a facility or licensed health 
care provider shall be a ground for disciplinary action contained in the 
facility’s or professional’s respective licensing chapter. 
 
36
 
(b) Any person who violates the confidentiality provisions of 
this section and s. 951.27 commits a misdemeanor of the first degree, 
punishable as provided in s. 775.082 or s. 775.083. 
§ 381.004(6), Fla. Stat. (1996 Supp.).  Nothing in this statute suggests that the 
Legislature intended to create a private remedy in tort, much less that the courts 
should create a brand new tort for the negligent disclosure of testing results based 
on this statute.   
 
Additionally, nowhere in the legislative history of this act is there any 
indication that the Legislature ever intended to provide a private remedy or alter 
the common law rule that a recoverable breach of confidentiality must be 
intentional.11  The Legislature has amended this statute numerous times since its 
inception.   Two of these amendments specifically address persons who could be 
prosecuted under this statute and the penalties available.  See ch. 89-350, § 6, at 
2242, Laws of Fla.; ch. 96-179, § 1, at 448, Laws of Fla.  In 1989, the Legislature 
                                          
 
11.  I am not necessarily endorsing the examination of legislative history in 
this case.  I believe such an approach is rarely an effective tool in gleaning the true 
intent of the Legislature.  See American Home Assur. Co. v. Plaza Materials Corp., 
908 So. 2d 360, 375-76 (Fla. 2005) (Cantero, J., concurring in part and dissenting 
in part) (discussing why legislative history, in particular staff analysis, is not 
determinative of legislative intent); see also Holly v. Auld, 450 So. 2d 217, 219 
(Fla. 1984) (quoting A.R. Douglass, Inc. v. McRainey, 137 So. 157, 159 (Fla. 
1931) (“When the language of the statute is clear and unambiguous and conveys a 
clear and definite meaning, there is no occasion for resorting to the rules of 
statutory interpretation and construction; the statute must be given its plain and 
obvious meaning.”)).  However, an examination of legislative history is consistent 
with the analysis suggested in the Restatement.  Restatement (Second) of Torts § 
874A (1979). 
 
 
37
revised section 381.609(6)(a), which was renumbered in 1991 to 381.004(6)(a), to 
apply to health care facilities in addition to health care providers.  Ch. 89-350, § 6, 
at 2242, Laws of Fla.; ch. 91-297, § 17, at 2841, Laws of Fla.  In 1996, persons 
who negligently violate the statute were included in the list of those guilty of a 
misdemeanor.  Ch. 96-179, § 1, at 448,  Laws of Fla. (omitting “intentionally”).  
Thus, there is absolutely no indication in either the language of the statute or in the 
legislative history that the Legislature intended to create a private civil remedy.12 
However, under the Restatement method of analyzing legislative intent, the 
court could find that the Legislature “had no specific intent in fact on the issue” of 
whether to create a private civil remedy.  Restatement (Second) of Torts § 874A 
cmt. d (1979).  While the language of section 381.004 does not provide for the 
creation of a private civil remedy, the language also does not expressly reject the 
possibility either.  The same is true of the statute’s legislative history.  Therefore, 
because the Legislature did not express an intention to either create or reject a 
private civil remedy, the court could conclude that the Legislature simply did not 
consider a private right to sue.  Since there is no evidence that the Legislature 
considered the issue of whether to create a private civil remedy, “the question of 
what it should do still remains before the court.”  Id.   
                                          
 
12.  Based on the Murthy analysis, this Court’s inquiry should stop at this 
point.  Where there is no basis to conclude that the Legislature intended that there 
be a private remedy under the facts alleged, the duty created by the statute should 
not be used by this Court to create one. 
 
38
In determining whether it would be appropriate to create a private remedy, a 
court should look at “[t]he nature of the legislative provision,” “[t]he significance 
of the purpose that the legislative body is seeking to effectuate,” “[t]he adequacy of 
existing remedies,” and “[t]he extent to which the tort action will aid or 
supplement or interfere with, existing remedies and other means of enforcement.”  
Restatement (Second) of Torts § 874A cmt. h (1979). 13  An examination of these 
factors in this case leads to the conclusion that no basis exists for the court to 
create a private civil remedy for the breach of confidentiality created in section 
381.004. 
 (i) The Nature of Section 381.00414 
 
The nature of section 381.004 does not provide a basis for the judiciary to 
create an additional remedy.  The statute is very specific in its regulation of 
conduct, clearly delineating what actions are prohibited.  Section 381.004(3)(f) 
provides: 
                                          
 
 
13.  The Restatement also suggests that the court consider “[t]he extent of 
the change in tort law,” a factor I discussed previously.  Restatement (Second) of 
Torts § 874A cmt. h (1979).  Additionally, the Restatement states that the court 
could consider “[t]he burden that the new cause of action will place on the judicial 
machinery.”  Id.     
 
14.  Under this factor, the Restatement suggests the court consider the 
specificity of “the legislative provision in its regulation of conduct” and whether 
the provision is “posed in broad, general terms that will acquire specific meaning 
only if—and after—the court has determined to supply the tort remedy. . . .”  Id. 
 
39
No person who has obtained or has knowledge of [an HIV] test result 
pursuant to this section may disclose or be compelled to disclose the 
identity of any person upon whom a test is performed, or the results of 
such a test in a manner which permits identification of the subject of 
the test . . . . 
This provision very clearly prohibits the disclosure of HIV test results or the 
identity of any person who receives an HIV test.  In other words, section 381.004 
imposes a strict duty of confidentiality on individuals who have knowledge of HIV 
testing.  The statute does not employ broad general terms that would only acquire 
specific meaning after the court supplies a remedy for the benefit of individuals 
receiving HIV tests.  Thus, court action is not required to give the statute or the 
duty the statute creates specific meaning.    
 (ii) The Purpose of Section 381.004 
Moreover, the Legislature’s purpose in enacting section 381.004 does not 
lend itself to the judicial creation of a private civil remedy.  The Florida 
Legislature was addressing a public health issue when it created the duty of 
confidentiality for HIV testing.  Section 381.004(1) provides: 
The Legislature finds that the use of tests designed to reveal a 
condition indicative of human immunodeficiency virus infection can 
be a valuable tool in protecting public health.  The Legislature finds 
that despite existing laws, regulations, and professional standards 
which require or promote the informed, voluntary, and confidential 
use of tests designed to reveal human immunodeficiency virus 
infections, many members of the public are deterred from seeking 
such testing because they misunderstand the nature of the test or fear 
that tests results will be disclosed without their consent.  The 
Legislature finds that the public health will be served by facilitating 
 
40
informed, voluntary, and confidential use of tests designed to detect 
human immunodeficiency virus infection. 
The Legislature was looking for ways to encourage HIV testing as a means of 
protecting public health.  The Legislature was not seeking to remedy private harms 
suffered by specific individuals through the use of monetary damages.  From the 
statement of its purpose in enacting section 381.004, it is clear that the Legislature 
did not intend to create a private tort remedy, much less that the courts would 
subsequently create a brand new tort for the negligent disclosure of testing results 
based on this statute.  
(iii) Adequacy of Existing Remedies  
Further, the remedies provided by section 381.004 seem sufficient to 
effectuate the Legislature’s purpose of facilitating HIV testing for the protection of 
public health.  As stated previously, if the duty of confidentiality created in section 
381.004(3)(f) is breached, the individual offender is to be sanctioned 
administratively or punished criminally as provided by section 381.004(6).  I find 
no basis to conclude that these penalties are insufficient to ensure the 
confidentiality necessary to encourage HIV testing.  Nor do I find any basis to 
conclude that a private civil remedy would be a more efficacious deterrent for 
negligent breaches than facing the possibility of losing one’s professional license 
and livelihood as well as the possibility of criminal charges.  Disturbingly, the 
majority completely ignores this fundamental issue.  Nowhere does it explain how 
 
41
the creation of a new tort action will ensure greater compliance with the statutory 
duty of confidentiality.  Therefore, absent any reason to believe that the express 
statutory remedies as well as the preexisting common law remedies are insufficient 
to meet the Legislature’s purpose, this Court should not create a new, additional 
remedy for which the Legislature itself did not expressly provide.   
To summarize, the Florida Legislature was addressing a public health issue 
when it created the duty of confidentiality for HIV testing.  It was looking for ways 
to encourage HIV testing.  In creating this very specific duty, unlike in Gracey, the 
Legislature did not create gapfilling authority for the courts to create new 
remedies.  Instead, it selected both administrative and criminal remedies for 
breaches of this duty.  In making this selection, it did not provide for a private 
action in negligence, and none existed at the time the statute was enacted.  
Moreover, the existing remedies seem sufficient to accomplish the Legislature’s 
purpose.  Given these facts, I respectfully believe that the majority opinion is an 
abuse of this Court’s discretionary authority to fill any perceived remedial gap by 
creating a new private remedy.   
D.  Distinguishing Gracey 
Finally, this case is clearly distinguishable from Gracey, 837 So. 2d 348.  In 
Gracey, this Court made an exception to the impact rule for a complaint alleging 
negligent infliction of emotional injuries resulting from a psychotherapist’s breach 
 
42
of his statutorily created duty of confidentiality.  Id. at 351.  To reach its ultimate 
holding, the Court had to infer a private cause of action for the breach of the duty 
of confidentiality created by section 491.0147, Florida Statutes (1997).  Id.  
Unfortunately, the Gracey decision did not apply the analysis I discuss above.  
However, if the Court had applied this analysis, inferring a private cause of action 
using a recognized tort would have been justifiable.   
More particularly, Gracey is distinguishable from Abril for four reasons.  
First, in Gracey, the Court provided a private cause of action for the breach of a 
statutory duty using a preexisting tort rather than creating an entirely new cause of 
action.  Second, unlike the statute in Gracey, section 381.004 was enacted as a 
comprehensive effort to address a critical public health crisis.  Third, unlike section 
381.004, the statute in Gracey provided no remedy or sanction for a breach of the 
duty of confidentiality it imposed.  Indeed, the Gracey opinion emphasized this 
fact.  In light of the complete failure of that statute to provide a remedy for the duty 
created, it was appropriate for this Court to thoughtfully consider whether to infer 
that the Legislature would intend a private cause of action.  See generally 
Restatement (Second) of Torts § 874A (1979).15   
                                          
 
15.  For example, the Restatement discusses a relevant maxim of statutory 
construction, ubi ius ibi remedium, which suggests that “if the legislation created a 
right it must have been intended to create an adequate remedy to enforce that 
right.” Restatement (Second) of Torts § 874A cmt. c (1979).   
 
 
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Fourth, Gracey is distinguishable because the common law tort that arose 
from the breach of the duty of confidentiality under chapter 491 was a claim for 
breach of a fiduciary duty.  837 So. 2d at 357.  This difference in the nature of the 
duty owed is significant, especially as it relates to the certified question about the 
impact rule.16  The Abrils have not claimed the existence of a fiduciary duty.  It is 
one thing to permit damages for emotional disturbances caused by a 
psychotherapist’s breach of a “very special psychotherapist-patient confidential 
relationship.”  Gracey, 837 So. 2d at 352.  It is quite another to permit the same 
type of relief for the breach of a nonfiduciary, ordinary duty of care.   
Conclusion 
                                          
 
16.  In Gracey, this Court recognized that “the plaintiffs have presented a 
cognizable claim for recovery of emotional damages under the theory that there 
has been a breach of fiduciary duty arising from the very special psychotherapist-
patient confidential relationship recognized and created under section 491.0147 of 
the Florida Statutes.”  Id. at 352 (emphasis added).  This Court then explained the 
nature of a fiduciary relationship, stating that “[i]f a relation of trust and 
confidence exists between the parties (that is to say, where confidence is reposed 
by one party and a trust accepted by the other, or where confidence has been 
acquired and abused), that is sufficient as a predicate for relief.  The origin of the 
confidence is immaterial.”  Id.  (quoting Quinn v. Phipps, 113 So. 419, 421 (Fla. 
1927)).  The nature of the duty in an ordinary negligence action does not require a 
special relationship of confidence between the plaintiff and the defendant.  Rather, 
the duty is an “obligation, recognized by the law, requiring the [defendant] to 
conform to a certain standard of conduct, for the protection of others against 
unreasonable risks.”  Clay Elec. Coop., Inc. v. Johnson, 873 So. 2d 1182, 1185 
(Fla. 2003) (quoting Prosser and Keaton on the Law of Torts 164-65 (W. Page 
Keeton, et al. eds., 5th ed. 1984)) (emphasis added).     
 
 
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Respectfully, as I have outlined in this dissent, the majority opinion in this 
case is, at best, unfortunate.  The question it answers is not supported by the 
record.  The answer given is much broader than necessary for the medical 
malpractice claim pled.  And, as I have attempted to explain, adding to the 
statutory remedies by modifying or abrogating the common law without any 
meaningful consideration of legislative intent violates the Restatement and the 
precedent of this Court that recognizes the judiciary’s limited policymaking role in 
our form of government.  Increasingly complex state legislation, coupled with the 
social cost of a much higher volume of litigation, strongly supports the desirability 
of a careful judicial scrutiny of legislative intent.  In this light, if properly analyzed, 
the Abrils do not have a common law cause of action for a negligent breach of 
confidentiality or negligent invasion of privacy.   The Abrils have failed to 
establish, and the Second District as well as the majority have failed to identify, 
any legislative intent that would support adding this new common law remedy to 
the statutory remedies already provided.  Given the above, I would quash the 
district court’s decision.  Therefore, I dissent.   
WELLS, J., concurs. 
 
 
Application for Review of the Decision of the District Court of Appeal - Certified 
Great Public Importance  
 
 
Second District - Case No. 2D03-3123 
 
 
45
 
46
 
(Hendry County) 
 
Bill McCollum, Attorney General, Tallahassee, Florida and David J. Glantz, 
Assistant Attorney General, Fort Lauderdale, Florida, 
 
 
for Petitioner 
 
 
Dick W. Mounts, Minerva, Ohio, 
 
 
for Respondent 
 
Robert S. Glazier, Miami, Florida, on behalf of Academy of Florida Trial Lawyers, 
 
 
as Amicus Curiae