Doctor Shopping and Unlawful Police Investigation

           The facts in the case of the State of Florida versus Jeffrey Singming Sun are as follows:

 

          "A deputy arrested Jeffrey Sun's brother for driving under the influence. In the car, the deputy found a notebook. Seeing that the notebook contained information on different pharmacies and dollar amounts, the deputy suspected doctor shopping. This suspicion led him to turn the notebook over to Detective Eric Keith. Detective Keith inspected the notebook and started an investigation that brought him to a CVS pharmacy in Juno Beach. There, Detective Keith sought the brother's prescription history. The pharmacist helpfully pointed out that the brother had a twin, Sun, and gave Detective Keith patient profiles for both men. Visiting several other area pharmacies, Detective Keith obtained Sun's patient profile from each, all without a [search] warrant or a subpoena.

 

          The investigation shifted into its next phase. Detective Keith compared all of Sun's patient profiles to determine whether Sun had gotten the same or similar medications from two or more physicians within a thirty-day period. Sun had. Detective Keith proceeded to contact the three prescribing physicians. He asked each if they had a patient in their care with Sun's name and birth date, and each said yes. When asked, each doctor denied knowing Sun had been seeing other doctors who had been giving him the same or similar prescriptions. They provided written statements to that effect and handed over Sun's signed patient contracts. In his [report], Detective Keith noted '[the doctors] did not disclose the nature of any of Sun's underlying health condition(s) that [necessitated] issuance of the prescriptions.'  As with the pharmacy records, Detective Keith had neither a warrant nor a subpoena for these items."

 

          As a result of the detective's investigation, the Office of the State Attorney charged Mr. Sun with trafficking in oxycodone and withholding information from a doctor in order to obtain a prescription for a controlled substance when the person has obtained the same or similar prescription from another doctor within the past 30 days (more commonly known as doctor shopping).
 
          
          Mr. Sun's case eventually reached Florida's Fourth District Court of Appeal which decided the following four issues:
 
 
           1.  Whether Sun's patient contracts were protected from examination by Detective Keith because of Sun's right to privacy in his medical records;
 
 
          2.  Whether the doctors' statements to Detective Keith about Sun violated the doctor-patient privilege that Sun had with his doctors;
 
 
          3.  Whether the trial judge was correct when he suppressed Sun's patient contracts and the doctors' statements to Detective Keith about Sun; and
 
 
          4.  Whether the trial judge should have suppressed the pharmacy records that the detective obtained without a search warrant or subpoena.
 
 
          Regarding the first issue, the appellate court ruled that Florida law requires the police to obtain a subpoena after providing notice to a patient before they may seize a patient's medical records.  Because Detective Keith did not obtain a subpoena in this case, it was unlawful for him to seize Sun's medical records.
 
 
          Regarding the second issue, the appellate court likewise ruled that Florida law requires the police to obtain a subpoena before they are allowed to elicit confidential information from a patient's doctor.  Because the detective did not obtain such a subpoena in this case, it was unlawful for him to elicit such information from Sun's doctors.
 
 
          Regarding the third issue, the appellate court ruled that the trial judge was correct to suppress Sun's patient contracts as well as the doctors' statements to Detective Keith about Sun because "suppression is the only remedy to sanction [Detective Keith's] misconduct and deter similar misconduct. . . .  Without court intervention and review as mandated by statute, countless innocent patient records are subject to examination and review by well-meaning but misguided law enforcement officials."
 
 
          Regarding the last issue, the appellate court stated that Florida law does authorize law-enforcement officers to obtain patient pharmacy records without first acquiring a search warrant or subpoena.  Therefore, it was lawful for Detective Keith to seize Sun's pharmacy records in this case.

Doctor Shopping and Your Obligation to Disclose Information About Previously-Obtained Prescriptions

          Florida's doctor-shopping law states that it is illegal for any person "[t]o withhold information from a [doctor] from whom the person seeks to obtain a controlled substance or a prescription for a controlled substance that the person making the request has received a controlled substance or a prescription for a controlled substance of like therapeutic use from another [doctor] within the previous 30 days."

 

          In the case of Knipp versus State of Florida, the issue was whether an individual has a legal obligation to disclose to a doctor that he has obtained a similar prescription within the previous 30 days from another doctor when the second doctor does not ask him about any previously-obtained prescriptions.

 

          In this particular case, Mr. Knipp obtained a prescription from a doctor in Broward County Florida on November 3, 2008 and three days later obtained another prescription for the same medicine from another doctor in Broward County.  There was no evidence that Knipp affirmatively misled either doctor, nor was there any evidence that either doctor asked him if he had received a similar prescription from another doctor within the previous 30 days.

 

          Florida's Fourth District Court of Appeal began its analysis by noting that Florida's doctor-shopping law does not define the word "withhold."  In an attempt to clarify that word's meaning, the appellate court stated that "[w]hether an individual has actually withheld information in violation of the statute depends on whether he requested a controlled substance and failed to disclose the fact that he received a drug of like therapeutic use within the previous thirty days. In other words, the statute requires that an individual affirmatively requesting a substance provide information to the [doctor]."

 

          The court continued on to state that Florida's doctor-shopping law "unambiguously makes it a crime for a person seeking a prescription for a controlled substance not to inform the physician that the person has already obtained a prescription for the same or similar substance within the last thirty days. The statute does not qualify the withholding of information by requiring an affirmative request for such information."

 

          Although Mr. Knipp lost on the doctor-shopping issue, there was still some good news for him in the court's decision.  Knipp was originally charged not only with doctor shopping but also with trafficking in oxycodone because the amount of oxycodone he had in his possession when he was searched by the police exceeded the legal limit set by Florida's trafficking statute.  Knipp argued that he was not guilty of trafficking because he had a valid prescription for the oxycodone which had been written by a licensed physician, and Florida law provides an exclusion from prosecution in such instances.

 

          The prosecutor responded by stating that Knipp was guilty of trafficking in oxycodone because his prescription was obtained in violation of the doctor-shopping statute and that therefore the exclusion did not apply in his case.

 

          The appellate court settled the matter by siding with Knipp.  The court stated that when a person possesses a prescription issued by a licensed doctor in the normal course of business, that individual may rely upon the exclusion provided by Florida law regardless of whether he has violated the doctor-shopping statute.

Your Pharmacy Records and Doctor Shopping

          Recently, police here in Florida have been going to different pharmacies and obtaining copies of the pharmacy records of individuals suspected of doctor shopping.  After some of those individuals were later charged with violating Florida's doctor-shopping law, they argued to a judge that their rights were violated when the police obtained their records without a search warrant.

 

         One such case in which this occurred was State of Florida v. Cater in which Ms. Carter argued that:

 

          1.  The warrantless seizure of her prescription records violated her constitutional rights to privacy and due process of law.

 

          2.  Her pharmacy could not legally give the police her records unless she was first given notice and the opportunity to either consent to the release of her records or else have the issue decided by a judge. 

 

          The trial judge agreed with Ms. Carter and granted her motion to suppress her pharmacy records that were seized by the police without a warrant.

 

           However, Florida's First District Court of Appeal reversed the lower-court's ruling on several different grounds including:

 

          1.  Neither Florida statute 893.07(4) nor 465.017(2)(a) require the police to obtain a subpoena or search warrant before seizing someone's pharmacy records if the police reasonably suspect that person of being involved in doctor shopping.  Additionally, neither of these statutes require that a patient be given prior notice that the police intend to seize her pharmacy records.

 

          2.  The federal Health Insurance Portability and Accountability Act ("HIPPA") does not govern the conduct of law enforcement officers or prosecutors.  However, even if it did govern such conduct, it was not violated in this particular case.  And even if HIPPA had been violated in this particular case (which it was not), the proper remedy would be for a court to impose fines and imprisonment, not suppress evidence.

 

 

           3.  Lastly, although article I, section 23 of the Florida Constitution does indeed provide for a right of privacy, that right is not absolute insofar as a patient's right to privacy in her medical records is concerned.  That right must yield to a compelling government interest such as the control and prosecution of criminal activity.