La responsabilité des établissements publics de santé mentale du fait de leurs patients ?

C’est une histoire d’assurances et de gros sous qui est à l’origine d’un arrêt peu orthodoxe, il faut le reconnaître. Après une première tentative de suicide en immobilisant un véhicule automobile sur un passage à niveau, Mme D. a été placée, à sa demande, dans l’établissement public de santé mentale des Flandres. Dans le cadre de cette hospitalisation, elle bénéficiait d’autorisations de sorties et de permissions pour les week-ends, afin de retrouver sa famille.

Un jour, après avoir participé à un atelier de détente musicale hors de l’établissement, et alors qu’elle devait en principe regagner celui-ci, elle a trouvé les clés de la voiture d’une autre patiente, stationnée dans la cour de l’établissement, a pu partir du centre hospitalier à bord de l’automobile avant de tenter dans la soirée de se suicider en immobilisant le véhicule sur une voie ferrée à Esquelbecq, provoquant un grave accident impliquant un train de marchandises.

La société CIC Assurances Serenis, assureur du véhicule volé à Mme B., a dû indemniser cette dernière ainsi que la SNCF des dommages causés à ses biens immobiliers et mobiliers. La société a alors demandé le remboursement des frais en cause à l’établissement de santé.

La Cour administrative d’appel de Douai a fait droit à la requête et a indiqué notamment :

« qu’eu égard à une précédente tentative de suicide qui avait motivé son hospitalisation, et bien que Mme D. bénéficiait d’un régime de placement libre et ne présentait pas de symptômes particuliers, en dépit de la nervosité constatée par son mari, dans les heures précédant sa nouvelle tentative, sa sortie étant prévue le 18 juillet 2001, il appartenait à l’établissement public de santé mentale des Flandres, s’il n’était pas tenu à une surveillance spéciale de la malade compte tenu de son régime d’hospitalisation et de son comportement, de s’assurer du retour de la patiente qui restait sous sa responsabilité lors des sorties qu’elle effectuait pour suivre dans le cadre du traitement des activités hors de l’établissement ; que l’établissement public de santé mentale des Flandres, ainsi qu’il résulte des procès-verbaux dressés par la gendarmerie après l’accident, n’a averti l’époux de Mme D. qu’à 19 heures, et n’a procédé à aucune diligence nécessaire pour avertir les services de la gendarmerie, qui n’ont été informés de l’accident que tard dans la nuit par la SNCF, afin que ceux-ci organisent des recherches à l’extérieur de l’établissement ; que cette carence doit être regardée comme constitutive d’une faute du service public hospitalier de nature à engager la responsabilité de l’établissement public de santé mentale des Flandres » ((CAA Douai, 10 avril 2007, n° 06DA01158, AJDA 2007, p. 1727.)).

Voici donc un arrêt qui aura pour effet de rappeler aux directeurs d’établissements spécialisés leur responsabilité vis-à-vis de patients, fussent-ils en hospitalisation libre, même s’ils se trouvent à l’extérieur de l’établissement dans le cadre des sorties autorisées.

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