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
LIABILITY FOR PRODUCTS
Liability for Health Products
Medications, vaccines, blood derivatives, and medical equipment are considered health products. There are two types of product liability:
1. Liability for defective products
A product is considered defective if it does not achieve its intended purpose or if its presentation does not conform to expectations.
For example, regarding a medication, it would be deemed defective if it does not meet its intended goals or if it has effects that were not disclosed in the instructions.
It will be necessary to demonstrate a causal link between the use of the product and the damages claimed.
Case law holds that the causal link can be presumed if significant, precise, and consistent evidence is presented. For instance, the French Court of Cassation has ruled that a clear and consistent body of evidence could suffice to prove the link between a vaccine and the onset of a disease.
The European Court of Justice has upheld this position. In the event of harm caused by a defective product, the responsible parties must compensate all damages suffered by the victims. The liable parties may include hospitals, as they are responsible for health products, and manufacturers, as producers of health products.
2. Liability for non-defective products
The liability for health products differs if the product is not considered defective (non-defective products).
In such cases, the liability mechanism will be based on medical accidents or therapeutic hazards. Victims of a serious medical accident originating from a preventive measure, diagnostic act, or treatment act will be compensated under medical accident insurance.
An accident is considered serious when the victim suffers from:
• A permanent physical or mental impairment greater than 24%,
• A temporary cessation of professional activities for at least six consecutive months or six non-consecutive months within a 12-month period,
• Temporary symptoms leading to a functional deficit of 50% or more for at least six consecutive months or six non-consecutive months within a 12-month period.
A serious medical accident can also include an iatrogenic condition or nosocomial infection that causes particularly severe issues, including economic consequences on the victim’s living conditions. Just like non-fault medical accidents, damages resulting from non-defective health products can be compensated under the therapeutic hazard if the consequences are severe, as defined above. Therapeutic hazards are compensated by ONIAM (National Office for Medical Accident Compensation).