While the importance of medical science to human health is undeniable, unintended consequences can sometimes arise during medical procedures. While these situations are not always the result of medical error, in some cases, a patient may be harmed as a result of the negligent actions or negligence of the doctor or hospital. This is where the concept of “malpractice” comes into play. In a city like Antalya, home to large and sophisticated healthcare institutions, malpractice claims can arise due to the density of medical practices. In such cases, how the hospital and doctor’s liability for damages is determined and whether this liability is shared is of paramount importance.
Malpractice lawsuits are extremely sensitive and complex processes, both legally and ethically. While the goal is to recover material and moral damages suffered by the patient, the obligation of medical professionals to act in accordance with professional standards is also evaluated. In this article, we will examine in detail the meaning of medical malpractice, the legal basis for hospital and doctor liability, and how these responsibilities are shared, specifically in malpractice cases in Antalya.
What is Malpractice? Legal Definition of Medical Malpractice
Malpractice, also known as medical malpractice, is the failure of a healthcare professional (doctor, nurse, dentist, etc.) to adequately utilize their professional knowledge and skills, act contrary to generally accepted medical standards, or fail to exercise due care, resulting in harm to a patient. This can occur not only through an active action but also through failure to do something that should have been done (negligence).
In order to talk about the existence of malpractice, some basic elements must be present:
1. Physician’s Fault: The physician’s act or omission in violation of professional standards. This fault can range from slight negligence to gross negligence.
2. Harm: The material or moral harm suffered by the patient as a result of medical practice. This harm may be physical, psychological, or economic.
3. Causal Link: There must be a direct causal relationship between the physician’s negligent act and the harm suffered by the patient. In other words, the harm must be caused by the physician’s negligent act.
4. Unlawfulness: The physician’s action is unlawful, that is, it is not in accordance with the law or professional ethical rules.
It’s important to note that not every unsuccessful treatment or undesirable outcome is considered malpractice. Complications related to the inherent risks of medicine, the patient’s characteristics, or the course of treatment can arise without the physician’s fault. The primary criterion in a malpractice claim is whether the physician “exercised the care expected of an average physician.”
The Nature of the Legal Relationship Between the Hospital and the Doctor
Determining liability in malpractice cases can vary depending on the legal relationship between the hospital and the doctor. A proper analysis of this relationship determines the extent to which each party will be held liable for damages.
Doctor’s Responsibility: Power of Attorney and Duty of Care
The relationship between a patient and a doctor generally has the character of a “contract of agency.” According to the Turkish Code of Obligations, a contract of agency is a contract in which the agent (doctor) undertakes to perform a task in accordance with the interests and will of the principal (patient). The basis of this contract is the doctor’s “duty of care.” The doctor is obligated to provide treatment using professional knowledge and skills, complying with generally accepted principles of medical science, and demonstrating up-to-date and due diligence.
If a doctor breaches their duty of care—that is, if they harm a patient by acting contrary to medical standards in processes such as making a diagnosis, administering treatment, performing surgery, prescribing medication, or providing information to the patient—they are liable for their own negligence. This liability is a contractual liability, as required by the contract of agency. However, in some cases, the doctor’s actions may also constitute tort.
Hospital Responsibility: Corporate Responsibility and Distinctive Elements
As institutional providers of healthcare services, hospitals can be held accountable in various ways for the medical practices performed within their organization. Hospital liability is generally examined under the following headings:
1. Organizational Failure: This failure stems from the hospital’s failure to properly organize healthcare services to provide them in a complete and safe manner. For example, inadequate or defective medical equipment, poor hygiene, insufficient and unqualified staff, and disruptions to emergency services may indicate organizational failure.
2. Selection Fault: This occurs when the hospital does not show due care when selecting doctors, nurses or other healthcare personnel, that is, it employs incompetent or unqualified people.
3. Supervision Failure: The hospital is responsible for the damages that occur as a result of not adequately supervising and monitoring the activities of its personnel.
4. Liability for the Acts of Assistants: Pursuant to Article 66 of the Turkish Code of Obligations, a hospital can be held liable for damages caused by doctors, nurses, and other healthcare personnel (assistant personnel) employed by the hospital while performing their duties, even if they are not at fault. This is known as “employer liability” and can occur regardless of the hospital’s fault.
5. Liability Arising from the Hospital Admission Contract: When a patient is admitted to a hospital, an implicit or explicit hospital admission contract is established between the hospital and the patient. This contract creates the hospital’s obligation to provide the patient with the necessary medical services. If the hospital breaches this obligation, it is subject to contractual liability.
Foundations of Joint Liability: Those Who Cause Harm Together
One of the most common situations in malpractice lawsuits in Antalya and throughout Türkiye is the “joint liability” of a hospital and a doctor. Joint liability means that more than one person is jointly and individually responsible for the same damage. In other words, the injured patient can claim the full amount of the damages from either the doctor or the hospital. It is possible to name both the hospital and the doctor as joint defendants in a lawsuit.
This shared responsibility typically arises in the following situations:
* Combination of the Hospital’s Organizational Fault and the Doctor’s Fault: For example, the hospital provides inadequate equipment and the doctor performs the intervention incorrectly despite this inadequacy.
* Liability for the Acts of Assistants and the Doctor’s Own Fault: The patient is harmed due to the doctor’s own faulty action, and the hospital is also responsible for the acts of assistants due to this action of the doctor, in accordance with the principle of liability.
* Negligence of a Freelance Doctor within the Hospital: In some cases, a hospital may be held liable for the negligent actions of a freelance doctor (contracted or freelance). This may also result in liability, particularly if the hospital allows the doctor to provide medical services within its own organization and these services are perceived as under the hospital’s brand.
Pursuant to the relevant articles of the Turkish Code of Obligations, when multiple parties are jointly and severally liable for the same damage, the injured party may claim the full amount of the damage from whichever party they choose. The party who paid the damage has a “right of recourse” (the right to claim reimbursement in proportion to the payment) against the other party responsible. The exercise of this right of recourse is determined by the degree of fault in the internal relationship.
Process and Evidence in Malpractice Cases in Antalya
For a patient or relative considering filing a malpractice lawsuit in Antalya, it is critical to know how the legal process works and what evidence is important.
Filing a Lawsuit and Statute of Limitations
Malpractice lawsuits are generally subject to statutes of limitations, which begin to run from the date the patient learns about the damages suffered and who is responsible for them. According to the Turkish Code of Obligations, the statute of limitations for compensation claims arising from tort is two years from the date the injured party learns about the damages and who is liable for compensation, and in any case, ten years from the date the act was committed. Statutes of limitations may vary for liabilities arising from contracts of agency. These periods should be carefully monitored and determined with the assistance of a lawyer to avoid loss of rights.
A lawsuit is filed by the injured patient, or by the patient’s heirs in the event of their death, in the competent court (usually the Civil Court of First Instance). A malpractice case in Antalya should be filed with the Antalya Courthouse.
Collection of Evidence and Expert Reports
In malpractice cases, the burden of proof rests with the claimant. In other words, the patient must prove the doctor’s or hospital’s fault and the causal link between that fault and the damage. Accurate and complete collection of evidence is crucial in this regard:
* Patient File and Medical Records: All records related to the treatment process (e.g., summary report, test results, surgical notes, patient observation forms, nursing notes, medication follow-up charts, etc.) constitute the primary evidence in the case. These records objectively present the physician’s and hospital’s practices.
* Expert Reports: Due to the technical nature of medical matters, courts often request reports from expert panels composed of physicians specializing in their respective fields. These reports assess whether medical practice complied with applicable standards, whether a defect existed, and whether this defect caused harm. Expert reports significantly influence the course of the case.
* Witness Statements: Statements of people who witnessed the treatment process (patient relatives, other healthcare personnel, etc.) can also be used as evidence.
* Imaging and Laboratory Results: Imaging results such as X-ray, MRI, tomography and laboratory results such as blood tests and pathology are also important evidence in the file.
Compensation Types and Calculation
Compensation for damages suffered by the patient as a result of malpractice is handled under two main headings: pecuniary damages and non-pecuniary damages.
Financial Compensation
Financial compensation aims to compensate a patient for economic losses suffered directly or indirectly as a result of medical error. These losses may include:
* Treatment Expenses: Additional treatment, medicine, surgery and care expenses arising from defective treatment.
* Loss of Earnings: Current and future losses of income suffered by the patient due to temporary or permanent disability.
* Compensation for Loss of Support: In the event of the patient’s death, the financial losses suffered by the relatives (spouse, children, parents) who are deprived of the support of the deceased.
* Funeral and Burial Expenses: Funeral and burial expenses in malpractice cases resulting in death.
The calculation of material compensation is made by expert witnesses based on concrete evidence and scientific data.
Non-pecuniary Damages
Non-pecuniary damages are compensation for intangible losses such as pain, suffering, distress, psychological trauma, and diminished quality of life experienced by a patient. The aim is to alleviate the physical and mental suffering suffered by a patient due to malpractice. The amount of non-pecuniary damages is at the discretion of the judge and is determined by considering factors such as the severity of the damage, the social and economic circumstances of the parties, and the manner in which the incident occurred. Its purpose is not to enrich the victim, but to alleviate the profound distress experienced by the victim.
Malpractice litigation in Antalya is crucial for both protecting patient rights and improving the quality of healthcare. Given the complex nature and legal intricacies of such cases, seeking support from an expert law firm is essential to prevent loss of rights and achieve justice. For victims of medical malpractice, seeking legal guidance during these challenging times is a critical step for both their own well-being and the public’s health awareness.