Pas de présomption de faute en cas de dommage dû à une intubation en vue d’une anesthésie

FlickR - Resus 2005_0037 - BobTheCorkDwarfUne patiente a recherché la responsabilité pour faute du centre hospitalier universitaire de Montpellier, auquel elle imputait la perte d’une dent lors des opérations d’anesthésie avant une intervention chirurgicale en vue de la pose d’une prothèse du genou.

Pour juger que le dommage, alors même qu’il était la conséquence directe de l’intubation réalisée en vue de l’anesthésie générale, n’engageait pas la responsabilité du centre hospitalier, la cour administrative d’appel a estimé qu’il résultait notamment du rapport d’expertise que le praticien n’avait, en procédant à cette intubation, ni méconnu les règles de l’art, ni commis aucune faute.

Ce faisant, selon le Conseil d’Etat ((CE, 21 oct. 2009, Altet-Caubissens, n° 314759.)), la cour n’a pas inexactement qualifié les faits qui lui étaient soumis. Elle n’a pas davantage entaché son arrêt d’erreur de droit, dès lors que l’intubation d’un patient en vue d’une anesthésie générale ne peut être regardée comme un geste courant à caractère bénin dont les conséquences dommageables, lorsqu’elles sont sans rapport avec l’état initial du patient, seraient présumées révéler une faute dans l’organisation ou le fonctionnement du service ((CE, Ass., 7 mars 1958, Secr. État Santé publ. c/ Dejous : Rec. CE 1958, p. 153. – CE, 22 déc. 1976, AP Paris c/ Mme Derridj ; Rec. CE 1976, p. 576.)).

Les termes de l’arrêt du 21 octobre dernier méritent une large reproduction :

« Considérant qu’il résulte des pièces du dossier soumis aux juges du fond que Mme A a subi, le 24 avril 2002 au centre hospitalier universitaire de Montpellier une intervention chirurgicale en vue de la pose d’une prothèse du genou ; que lors des opérations d’anesthésie, elle a perdu une dent ; qu’imputant ce dommage à une faute de l’établissement, elle a recherché la responsabilité du centre hospitalier ; que par un jugement du 9 mai 2006, le tribunal administratif de Montpellier a partiellement fait droit à sa demande et condamné le centre hospitalier à réparer les deux tiers des préjudices subis et à lui verser en conséquence une somme de 2 468,40 euros ; que, statuant sur l’appel du centre hospitalier, la cour administrative d’appel de Marseille a, par un arrêt du 28 février 2008, annulé ce jugement et rejeté la demande indemnitaire ; que Mme A se pourvoit en cassation contre cet arrêt ;

Considérant que, pour juger que le dommage subi par la requérante, alors même qu’il était la conséquence directe de l’intubation réalisée en vue de l’anesthésie générale, n’engageait pas la responsabilité du centre hospitalier, la cour administrative d’appel a estimé qu’il résultait de l’instruction et notamment du rapport d’expertise que le praticien n’avait, en procédant à cette intubation, ni méconnu les règles de l’art, ni commis aucune faute ; que, ce faisant, la cour n’a pas inexactement qualifié les faits qui lui étaient soumis ; qu’elle n’a pas davantage entaché son arrêt d’erreur de droit, dès lors que l’intubation d’un patient en vue d’une anesthésie générale ne peut être regardée comme un geste courant à caractère bénin dont les conséquences dommageables, lorsqu’elles sont sans rapport avec l’état initial du patient, seraient présumées révéler une faute dans l’organisation ou le fonctionnement du service ; que par suite, Mme A n’est pas fondée à demander l’annulation de l’arrêt attaqué ; »

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