Recours subrogatoire de l’assureur d’une clinique : lorsque le médecin fautif est salarié

Le code des assurances prévoit une immunité ne bénéficiant qu’au médecin préposé (art. L. 121-12, alinéa 3) mais cet article ne fait pas obstacle au recours subrogatoire de l’assureur qui a indemnisé la victime contre l’assureur du responsable : tel est l’enseignement de l’arrêt suivant ((Cass., Civ. 1ère, 12 juillet 2007, n° W 06-12.624 et n° P 06-13.790, arrêt n° 936 F-PB.)).

En l’espèce, une radiothérapie orbitaire dont l’irradiation prescrite a été sur-dosée a rendu un patient totalement aveugle. La victime a assigné aux fins de réparation de son préjudice le radiothérapeute et l’établissement de santé privé ainsi que leurs assureurs de responsabilité civile respectifs, soit quatre parties au procès civil.

Par jugement du 5 juillet 2001, le tribunal de grande instance déclare responsable pour faute le radiothérapeute et le condamne in solidum avec son assureur. En revanche, la Cour d’appel d’Aix-en-Provence, par arrêt du 14 décembre 2005, a retenu la seule responsabilité de l’établissement de santé, tout en contraignant l’assureur du radiothérapeute à relever et garantir l’assureur de la clinique pour toutes les condamnations mises à sa charge.

La décision a fait l’objet de pourvois des deux parties :

  • Par l’assureur de l’établissement hospitalier, qui conteste sa responsabilité au motif que le médecin aurait exercé son intervention dans la continuité de son activité libérale. La Haute juridiction rappelle, à ce titre, le principe selon lequel le praticien salarié, qui agit sans excéder les limites de la mission qui lui est impartie par l’établissement de santé privé, n’engage pas sa responsabilité à l’égard du patient ((Cass. 1ère civ., 9 novembre 2004, n°01-17.908; cf. également C. Riot, L’exercice «subordonné» de l’art médical, D. 2006. Chron. 111 ; F. Chabas, La responsabilité personnelle de la sage-femme ou du médecin salarié, D. 2005. 253; J. Penneau, Droit médical: panorama 2004, D. 2005. 403.)).

La Cour de cassation rejette et apporte les précisions suivantes à la notion de « mission ». Lorsque le traitement mis en cause a été effectué, le praticien :

–     était sur le lieu et pendant son temps de travail ;

–     utilisait les outils du centre de traitement ;

–     ne dépassait pas les limites de sa mission, quand bien même une consultation privée préalable avait été effectuée.

  • Par l’assureur du radiothérapeute, qui conteste le droit à recours de l’assureur de l’établissement hospitalier, notamment sur le fondement de l’article L. 121-12, alinéa 3, du code des assurances, prévoyant des dérogations à la faculté de recours subrogatoire dont dispose l’assureur qui a indemnisé la victime pour les « […] préposés, employés, ouvriers ou domestiques […]».

C’est le sens même de l’immunité légale, dont bénéficie le préposé, qui est méconnu, celle-ci n’étant valable que pour les personnes nommément désignées par l’article L. 121-12, et non à leur assureur, lequel est tenu de prendre en charge les conséquences dommageables des fautes commises par son assuré.

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