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).
EXAMPLES OF ACCIDENT COMPENSATION
Examples of Compensation for Accidents
Traffic Accident
A woman, aged 45 at the time of the accident, was hit by a vehicle while riding her bike. She suffered a severe head injury with loss of consciousness and a fracture of the left temporal bone. Other injuries included a severe facial trauma with a fracture of the left zygomatic arch, a fracture of the left maxillary wall with hemato-sinus, a dental nerve contusion with hypostasia of the upper left dental arch, a fracture of the right lateral incisor, chest trauma, and a severe spinal injury with a comminuted fracture of the L1 vertebra.
The victim has suffered lasting consequences: left ankle sprain, left shoulder pain, phlebitis of the left lower limb, cervical pain, and depressive syndrome.
A permanent functional deficit of 28% was recorded, with a need for 4 hours of weekly domestic help, suffering evaluated at 5.5 out of 7, and future professional earnings loss estimated at €96,273.
The total compensation was €334,181.94.
A female passenger, aged 30 at the time of the accident, was involved in a professional trip accident. She was fully consolidated by age 37. She retained a permanent functional deficit of 30% due to 2,483 days of temporary functional deficit.
The total compensation was €124,607.94.
A 19-year-old woman, the victim of a traffic accident while walking, suffered a comminuted fracture of the upper left ulna requiring osteosynthesis, a severe sprain of the right knee with anterior cruciate ligament rupture and lateral collateral ligament rupture, leading to ligamentoplasty. The injuries required multiple hospitalizations.
The victim was consolidated a year later at age 20 and retained a permanent functional deficit of 10%, along with a permanent aesthetic injury evaluated at 3 out of 7. She also had a one-year school-related loss of €8,000 and temporary suffering evaluated at 4 out of 7.
The total compensation was €44,750.
A child, aged 10 at the time of a traffic accident, was riding his bike when the accident occurred. He was consolidated at age 21 with extremely serious sequelae.
His permanent functional deficit was evaluated at 95%, leading to €427,500.
The total compensation was €2,425,332, considering aesthetic injury, enjoyment loss, sexual harm, accommodation loss, suffering, temporary functional deficit, future medical expenses, adapted vehicle costs, third-party assistance, professional impact, and current healthcare costs.
Medical Liability
A man who underwent surgery for a herniated disc and suffered paraplegia was judged to have an abnormal outcome, given his prior health condition. The surgeon was found not to have committed a technical fault and it 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 the professional impact due to paraplegia, estimated at €40,000.
During a surgery, a patient’s spinal nerve was accidentally severed. The man suffered from pain and progressive motor deficits in his right shoulder. At the time of the accident, he was 37 years old and was consolidated at 39 years of age, two years later. The loss of chance was evaluated at 50%.
He was awarded a total of €18,980, including a permanent functional deficit of 13% (adjusted for the loss of chance), amounting to €9,800.
A woman staying in a rehabilitation and convalescence center following hip surgery was the victim of staff mishandling that caused the dislocation of her hip prosthesis.
The victim was temporarily unable to work for 5 months. She was 34 at the time of the incident, and consolidation was achieved 3 years later.
She was awarded €25,000 for her temporary and permanent functional deficits, plus €10,000 for suffering endured.
The total compensation was €42,000, including aesthetic and other damages.
Accidents of Daily Life
A child was involved in an accident during a football match at school. The responsibility of the child’s parents (the one causing the harm) was recognized.
The child retained lasting consequences, including a permanent injury valued at €16,500.
The total compensation amounted to €28,095.
A 13-year-old girl was involved in a ski accident, resulting in a complex fracture of the right elbow. Six months later, a dislocation of the right elbow was diagnosed, necessitating another surgical intervention. Two years later, further exams revealed a subluxation of the same elbow.
The victim was considered consolidated 3 years after the accident.
Suffering 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 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 age 47, two years after the accident.
She retained a permanent functional deficit of 15%, valued at €19,500, and was compensated with €10,000 for the suffering endured, evaluated at 4 out of 7.
Her total compensation was €42,584, after deducting social security-covered care costs.