Roebuck v. Mayo Clinic: A Crisis No More

By David Jang.

Article 18, Section 6 of the Arizona Constitution provides: “the right of action to recover damages for injuries shall never be abrogated, and the amount recovered shall not be subject to any statutory limitation.” This so-called “anti-abrogation clause” protects the ability to bring common-law tort claims by preventing liability waivers. During the COVID-19 pandemic, however, the Arizona legislature enacted A.R.S. § 12-516, limiting lawsuits against healthcare providers to only claims of gross negligence or willful misconduct. This pandemic-era liability shield effectively barred plaintiffs from raising ordinary negligence claims in medical malpractice suits whenever care was provided “in support of” a declared public health emergency. Then, on September 12, 2025, the Arizona Supreme Court held in Roebuck v. Mayo Clinic that A.R.S. § 12-516 violated the anti-abrogation clause, restoring negligence claims for COVID-era medical care. 

 

Background of the Case

 

This now-unconstitutional doctrine originated in April 2020 with then-Governor Doug Ducey’s “Good Samaritan” Executive Order 2020-27, which limited civil liability by presuming that healthcare professionals acted in good faith during the COVID-19 pandemic. The order was renewed twice in 2020 and codified by the Arizona legislature as A.R.S. § 12-516 in 2021. The statute insulated “health professionals” and “health care institutions” for care provided “in support of” a declared pandemic unless a plaintiff could prove gross negligence or willful misconduct by clear and convincing evidence, which is a much more stringent standard than normal negligence claims. The law applied retroactively, starting March 11, 2020.

 

Roebuck v. Mayo Clinic arose after Robin Roebuck was hospitalized for COVID-19 at the Mayo Clinic in April 2020. Roebuck alleged medical complications from a negligently performed arterial blood gas test during treatment and filed suit in 2021. Under Section 12-516, the trial court granted summary judgment for the Mayo Clinic. The Arizona Court of Appeals overturned the ruling in September 2023, holding that the statute was unconstitutional under the Arizona Constitution. The Arizona Supreme Court then granted review.

 

Arguments and the Court’s Reasoning

Roebuck argued that Section 12-516’s heightened “clear and convincing evidence” standard left many injured patients without a sufficient legal remedy, thus violating the anti-abrogation clause. Respondent Mayo Clinic argued that the statute was merely a “regulation” of negligence that stabilized hospital care during a national crisis. The Court, however, reasoned that medical negligence is a protected, statehood-era right of action. It also found that gross negligence is not a reasonable alternative to ordinary negligence due to the heightened mental state element, thus resulting in abrogation, not regulation. Instead of striking the entire statute, the Arizona Supreme Court severed the unconstitutional provisions regarding gross negligence and willful misconduct, leaving the non-abrogating parts of Section 12-516 for trial courts to parse. Specifically, the heightened burden of “clear and convincing evidence” was allowed to stand. However, the Court struck down the “wilful misconduct or gross negligence” requirement that had completely barred plaintiffs from bringing ordinary negligence claims. 

Doctrinal Consequences and Impact on Future Litigation

 

Arizona has long drawn a sharp line between regulating and abolishing a cause of action. In Kenyon v. Hammer, the Court refused to let an inflexible repose period shut out medical malpractice plaintiffs. Cronin v. Sheldon elaborated on the regulation-abrogation boundary, while Duncan v. Scottsdale Medical Imaging policed limits on statutory attempts to recharacterize core tort claim standards. In Torres v. JAI Dining, the court further clarified that Article 18, Section 6 of the Arizona Constitution only protects statehood-era torts while newer, purely statutory claims might not receive the same protection. 

 

In essence, the Roebuck decision held that burden-ratcheting combined with claim-swapping constitutes abrogation under the Arizona Constitution. The combination, namely eliminating ordinary negligence while substituting a higher burden, acted to functionally disappear the right entirely. Beyond health law, this means that future statutes cannot accomplish indirectly through narrower standards what the Constitution forbids directly. More generally speaking, emergency powers still have constitutional guardrails; the legislature may act in a crisis, but the Constitution does not go “offline.” While measures that regulate claims may pass muster, measures that erase core claims will not.

 

Plaintiffs may again bring ordinary negligence claims tied to pandemic-era medical care. Even so, the baseline mechanics of Arizona medical malpractice litigation remains the same.Due to the retroactive nature of the original statute, litigants may revisit cases that were dismissed under the statute. Whether such claims may be revived will now turn on statutes of limitations and accrual. 

 

Also of note is the fact that, on appeal from the Maricopa County Superior Court, the Arizona Court of Appeals rejected a Public Readiness and Emergency Preparedness Act (“PREP Act”) defense. Therefore, Roebuck does not alter federal preemption principles. Continued litigation is expected regarding whether interventions count as “covered countermeasures” under the PREP Act, which  often results in removal to federal court. 

 

Practical Impacts Across Arizona

 

Patients who believed they lacked remedies due to Section 12-516 now have a clearer path to file or re-file negligence suits, subject to timing rules. Of course, hospitals and clinicians therefore face renewed exposure for COVID-era decisions and actions. Litigants may expect intensified focus on documentation of triage protocols, scarcity of resources, staffing decisions, and patient communication. Insurance companies and risk management agencies will adjust reserves and claims strategies accordingly. In trial courts, motion practice is expected to cluster around: (1) what remains of Section 12-516 after severance; (2) how many surviving presumptions operate without abrogation; and (3) federal preemption and removal due to the PREP Act. Appellate courts are expected to generate clarifying opinions over the upcoming year. 

 

It is important to note that Roebuck does not forbid all emergency-period protections. Legislators who seek decisive medical action during crises still retain options more likely to pass constitutional muster. These include: rebuttable presumptions tied to documented reliance on contemporary CDC/ADHS guidance; procedural tools such as front-loaded expert affidavit deadlines; and targeted safe harbors tied to proven resource scarcity with explicit carve-outs for unreasonable deviations. 

 

Arizona in the Broader Landscape

 

Many other states adopted pandemic-era litigation shields that remain largely intact. Arizona’s strong anti-abrogation clause, which courts consistently enforce, makes the decision in Roebuck stand out. The same doctrine that limited repose in Kenyon, policed the regulation-abrogation line in Cronin, and narrowed the clause’s scope in Torres now limits COVID-era tort shields. Because ordinary negligence is a statehood-era claim, the legislature cannot temporarily raise the standard, as it did during COVID, without violating the Arizona Constitution.

 

Roebuck v. Mayo Clinic is an Arizona-specific reaffirmation that constitutional rights do not yield in times of crisis. Patients regain access to ordinary negligence claims for pandemic-period care, while healthcare providers face traditional negligence even during emergencies but retain protection though existing expert affidavit and standard-of-care rules. Lawmakers still have room to regulate, but not abrogate, so long as a meaningful negligence pathway remains. Roebuck will shape Arizona’s emergency statutes, hospital documentation of crisis-time decisions, and the method by which courts police the line between regulation and abrogation.