Background
Wyatt Dean Garrett, a former Army servicemember, suffered chronic back pain from a deployment injury and had been a patient at Sarasota Pain Management for over a decade. He was prescribed fentanyl products—a Duragesic transdermal patch for long-term relief and Actiq lozenges for breakthrough pain—which he used without incident for years. In 2018, responding to regulatory pressure on opioid prescribing, Dr. Chun, Garrett’s physician, began reducing his Actiq doses while noting Garrett’s stated preference to “rather die” than lose access to the medication.
In December 2018, the practice was sold to Physician Partners of America (PPOA) and placed under the supervision of Dr. James Adams, who was not certified in the specialized TIRF REMS program required to prescribe Actiq. On January 11, 2019, Advanced Practice Registered Nurse Agnes Lynch informed Garrett that his medications would be changed away from opioids. Garrett objected, terminated the doctor-patient relationship, and was discharged. Dr. Adams issued a final month’s supply, but the pharmacy refused to fill the Actiq prescription due to Dr. Adams’ lack of TIRF REMS certification. Despite consulting multiple other providers, Garrett could not find a pain management specialist willing to prescribe Actiq. He committed suicide on April 16, 2019, over ninety days after discharge.
Garrett’s widow sued Lynch and PPOA for medical malpractice and vicarious liability, arguing they owed a duty to Garrett even after discharge. The trial court granted summary judgment for the defendants on the ground that no duty existed post-discharge.
The Court’s Holding
The Second District affirmed, holding that Lynch and PPOA owed no legal duty to Garrett after the termination of the doctor-patient relationship. The court recognized that healthcare provider duties are “explicitly relational” and arise from and exist only during the patient relationship. Once Garrett discharged himself and was formally discharged, any duty ceased.
The court rejected the plaintiff’s arguments based on three legal sources. First, while Florida Statute § 766.102 establishes the standard of care for healthcare providers including nurse practitioners, it does not by itself establish a duty to former patients. Second, the landmark case Chirillo v. Granicz, which addressed a physician’s duty to prevent suicide, involved a patient still in active treatment; it did not support a duty after discharge. Third, Burley v. Vill. S., Inc., which found a duty owed by inpatient facilities to discharged patients, was distinguished because it involved specific statutory duties applicable only to inpatient settings, where duties are inherently higher than for outpatient care.
The court also rejected a last-minute argument that the mere act of issuing a prescription at discharge created an indefinite duty. It noted that even if Lynch had prescribed the Actiq (which she did not—Dr. Adams did), such a duty would have been limited to the thirty-day supply, not extending indefinitely or beyond the point when Garrett began seeing other physicians.
Key Takeaways
- Healthcare provider duties in Florida are relational and terminate when the patient-provider relationship ends through discharge, even in tragic circumstances.
- No statute or common-law doctrine imposes a duty on outpatient providers to former patients after discharge, and such duties exist at a lower level than duties owed to inpatient patients.
- The regulatory and social context of the opioid epidemic, while factually important to the case, does not create novel duties beyond existing law.
- A provider who has no pre-existing duty cannot undertake limited actions (like issuing a final prescription) and thereby create an indefinite, ongoing duty to a former patient.
Why It Matters
This decision provides critical clarification for healthcare providers navigating the tension between the opioid epidemic and patient autonomy. Providers who terminate care or transition patients—particularly in pain management—now have clearer guidance that their legal duty ends upon discharge, even when regulatory restrictions force changes to existing treatment protocols. The court’s rejection of liability for post-discharge conduct protects providers from claims arising from patients’ subsequent inability to access medications elsewhere.
For patients and their families, the decision establishes that the law recognizes no continuing duty of care once a patient has voluntarily terminated the relationship and been discharged. This has particular significance in pain management and psychiatric care, where patient autonomy in choosing medications and providers is often a central concern. The court’s holding underscores that patients bear responsibility for securing continuing care after discharge and that providers need not ensure continuity or prevent harm after the relationship ends.