L’avis de la CRCI ne lie pas l’ONIAM

Traditionnellement, lorsqu’un patient était victime d’un accident médical (ou aléa thérapeutique), il se tournait systématiquement vers les tribunaux – qu’ils soient administratifs ou judiciaires – pour réclamer une réparation de ses préjudices avec plus ou moins de succès.

La loi n°2002-303 du 4 mars 2002, plus connue sous le sobriquet de loi anti-Perruche ou encore sous l’appellation de loi Kouchner, a créé l’Office National d’Indemnisation des Accidents Médicaux, des affections iatrogènes et des infections nosocomiales (ONIAM), organisme chargé d’indemniser les patients victimes desdites affections.

Autrement dit, et pour aller vite, le patient a désormais le choix entre introduire une procédure juridictionnelle et tenter la voie amiable (ou extra-juridictionnelle) pour être indemnisé au titre de la solidarité nationale, étant précisé que ces deux options ne sont pas exclusives l’une de l’autre. Par exemple, si le requérant veut multiplier ses chances d’être indemnisé, il peut introduire les deux procédures simultanément, l’une devant le tribunal compétent, l’autre devant la Commission Régionale de Conciliation et d’Indemnisation (CRCI).

Lorsque le dommage est considéré par la CRCI comme relevant de la solidarité nationale (art. L. 1142-17 du code de la santé publique), cette dernière émet un avis à l’attention de l’ONIAM puis une offre d’indemnisation à l’attention de la victime. A l’occasion d’un litige, le juge administratif a été confronté à la question suivante : dans le silence des textes, l’avis de la CRCI s’impose-t-il à l’ONIAM de telle sorte que ce dernier serait en situation de compétence liée ?

Le juge des référés, c’est-à-dire le juge de l’urgence et de l’évidence par opposition au juge du fond qui tranche un litige collégialement et définitivement, a apporté une réponse négative ((CAA Versailles, 12 janv. 2006, Consorts Pellegrino, n°05VE01157)).

Par la qualité du juge qui s’est prononcé, il importe évidemment de relativiser l’importance de la solution ainsi donnée dès lors que le juge du fond en appel ne s’est pas prononcé et que, sur le fond du droit, une juridiction inférieure s’est prononcée en sens contraire ((TA Bastia, 12 sept. 2005, AJDA 2005, p. 2187)).

On retrouve alors le rôle traditionnellement unificateur de la plus haute juridiction de l’ordre administratif. En effet, faute de précisions apportées par les textes sur cette question, il conviendra d’attendre une position de principe définitivement arrêtée par le Conseil d’Etat.

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