Public hospital liability
PUBLIC HOSPITAL RESPONSIBILITY
A doctor practicing within a public hospital is not personally liable for harm caused to a patient due to their fault.
Indeed, the doctor acts as a public service agent, and the patient is considered a user of a public service. As such, only the public healthcare institution can be held liable.
If, however, the doctor commits a personal fault separate from their official duties, then civil liability may apply — but only in such cases.
A personal fault separate from official duties is defined by case law as a particularly serious fault that cannot reasonably be attributed to the normal functioning of the public service. This includes, for example, a fault committed with intent to harm, for personal gain, or a blatant breach of professional ethics.
Since the law of March 4, 2002, the administrative liability of public healthcare institutions can be invoked under Article L1142-1 of the Public Health Code, just like the liability of private healthcare professionals and institutions. Therefore, apart from the exceptional cases provided for in Article L1142-1, the administrative liability of a public healthcare institution can only be established if the patient provides proof of a fault, a damage, and a causal link between the two.
A medical expert assessment will be required to establish this fault. In principle, no judge will rule on medical liability without first obtaining the informed opinion of a qualified medical expert.
The competent courts for handling administrative liability of public healthcare institutions are:
• the Administrative Court at first instance,
• the Administrative Court of Appeal,
• and, if necessary, the Council of State (Conseil d’État).
PUBLIC HOSPITAL RESPONSIBILITY
PUBLIC HOSPITAL RESPONSIBILITY
A doctor practicing within a public hospital is not personally liable for harm caused to a patient due to their own fault.
Indeed, the doctor acts as a public service agent, while the patient is considered a public service user. Therefore, only the liability of the public healthcare institution can be engaged.
However, if the doctor commits what is known as a personal fault separable from their duties, they may then incur personal civil liability—but only under those specific circumstances.
A personal fault separable from official duties is defined by case law as a particularly serious fault that cannot reasonably be attributed to the functioning of the public service. Examples include misconduct committed with intent to harm, for personal gain, or a fault that is inexcusable under professional ethics.
Since the law of March 4, 2002, the administrative liability of public healthcare institutions may be invoked under Article L1142-1 of the Public Health Code, just like the liability of private professionals and institutions. Therefore, except in the exceptional cases mentioned in Article L1142-1, the administrative liability of a public healthcare institution can only be engaged if the patient proves the existence of a fault, a damage, and a causal link between the two.
A medical expert assessment will be required to establish such fault. In principle, no judge will rule on medical liability without first obtaining the opinion of a qualified expert.
The competent courts for hearing administrative liability cases involving public healthcare institutions are:
• the Administrative Court (first instance),
• the Administrative Court of Appeal,
• and, if necessary, the Council of State (Conseil d’État).
Public hospital liability
PUBLIC HOSPITAL RESPONSIBILITY
A doctor practicing within a public hospital is not personally liable for harm caused to a patient due to their own fault.
Indeed, the doctor acts as a public service agent, and the patient is considered a user of a public service. As a result, only the public institution’s liability may be engaged.
However, when the doctor commits what is known as a personal fault separable from their duties, they may then incur civil liability, but only in such cases.
Case law defines a personal fault separable from official duties as a particularly serious fault that cannot reasonably be attributed to the normal functioning of the service. This includes, for instance, a fault committed with intent to harm, for personal interest, or one that is inexcusable under professional ethics.
Since the law of March 4, 2002, the administrative liability of public healthcare institutions may be engaged under Article L1142-1 of the French Public Health Code, just like the liability of private professionals and institutions. Outside of exceptional circumstances provided for in Article L1142-1, the administrative liability of a public healthcare institution can only be established if the patient proves the existence of a fault, a damage, and a causal link between the two.
A medical expert assessment is required to demonstrate this fault. In principle, no judge will rule on medical liability without first obtaining the informed opinion of a qualified expert in the field.
The courts competent to hear cases involving the administrative liability of public healthcare institutions are:
• the Administrative Court at first instance,
• the Administrative Court of Appeal on appeal,
• and, if applicable, the Council of State (Conseil d’État).
Public Hospital Liability
Examples of Compensation
Examples of Compensation
Medical Liability
• A man operated on for a herniated disc and suffering from paraplegia, whose previous health condition was considered abnormal in evaluating the case. The surgeon was judged not to have committed a technical fault, and the incident was classified as a therapeutic hazard.
The victim received a total compensation of €326,385.
The main compensation was for future medical expenses, estimated at €228,353.02. The second-largest compensation was for professional impact due to paraplegia, estimated at €40,000.
• During surgery, a patient had his right spinal nerve severed by mistake. He suffered from pain and experienced progressive motor deficits in his right shoulder. At the time of the accident, he was 37 years old and was consolidated at 39 years old, 2 years after the accident. The loss of chance was evaluated at 50%.
He received a total compensation of €18,980, considering a permanent functional deficit of 13% (adjusted for the loss of chance).
• A woman staying at a rehabilitation and convalescence center following hip surgery became the victim of a staff error that caused the dislocation of her prosthesis.
The victim was temporarily unable to work for 5 months. She was 34 at the time of the incident, and her consolidation date was set 3 years later.
The victim received €25,000 for her temporary and permanent functional deficits and €10,000 for the suffering endured.
In total, the victim received €42,000, considering aesthetic and other damages.
• A woman suffered a lingual nerve injury following the extraction of a cyst around a wisdom tooth. She experienced difficulty eating and loss of somesthetic and taste sensations.
Accidents of Daily Life
• A child was involved in an accident during a football match at school. The responsibility of the child’s parents, who caused the harm, was recognized.
The child retained lasting consequences, including a permanent injury valued at €16,500.
The total compensation for the child was €28,095.
• A 13-year-old girl was involved in a ski accident, resulting in a complex fracture of her right elbow. Six months later, a right elbow dislocation was diagnosed, requiring another surgical intervention. Two years later, additional exams revealed a subluxation of the same elbow.
The victim was considered consolidated 3 years after the accident. The suffering endured was evaluated at 5.5 out of 7, mainly due to the 3 surgeries.
She retained a permanent functional deficit of 10% and a permanent aesthetic injury valued at 4 out of 7.
The total compensation for the young girl was €39,000.
• A woman fell in a building and suffered a left ankle injury, classified as a fracture. She underwent multiple surgeries and retained sequelae after consolidation at 47 years old (2 years after the accident).
She retained a permanent functional deficit of 15%, valued at €19,500, and was compensated €10,000 for the suffering endured, evaluated at 4 out of 7.
Her total compensation amounted to €42,584, after deducting the costs covered by social security.