Opinion ID: 1822772
Heading Depth: 1
Heading Rank: 6

Heading: The Abrils' Claim Is for Medical Malpractice

Text: 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 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.
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 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.
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 205. 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 (Fla.1973), as well as Lewis v. City of Miami, 127 Fla. 426, 173 So. 150 (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] 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 203. 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 recognizing a new common law cause of action for the negligent breach of the duty of confidentiality created by section 381.004(3)(f).
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 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 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. 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.
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. (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 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. 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.
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: 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.
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 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.
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 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.
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 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] 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.