(II) Compensation for medical accidents

Perhaps more radical were the new legislation’s provisions governing compensation for medical accidents. Here, the legislation of March 2002 was concerned to ensure compensation for the most serious consequences of medical accidents and thereby remove (p.154) the need for the courts to impose liabilities other than for fault.¹⁷⁶ The legislation set up a fund from which payments would be made in respect of nosocomial infections, iatrogenic conditions or medical accidents where these cause a patient abnormal consequences to the state of his or her health, the seriousness having a threshold of 25 per cent incapacity (whether permanent or temporary).¹⁷⁷ The justification for this compensation of the most serious consequences of ‘medical risks’ was ‘national solidarity’, that is the idea that the State as collective representative must support those of its citizens who have some special need. The legislation makes clear that this right to compensation arises only where there is no liability in any medical professional, health care provider or producer of products:¹⁷⁸ the new rights should not lead to the ‘irresponsibility’ of those concerned in health care.

At a practical level, the legislation set up new mediation mechanisms for patients suffering very serious harm (as earlier defined) allegedly as a result of their health care, with the idea that these will channel a claim either towards those liable or towards the new compensation fund.¹⁷⁹ This creates a ‘one-stop access’ for the settlement of claims to be administered by regional committees, though leaving the possibility of recourse to the courts (either civil or administrative) at any stage.¹⁸⁰ After an investigation, if a Commission finds a person (such as a hospital authority) liable for the patient’s harm, then its insurer must make an offer of compensation within four months; the patient is free either to accept this offer or proceed to litigation. If no offer is made, then the new national fund pays the compensation and may itself proceed against the person responsible.¹⁸¹ On the other hand, where the commission finds that the patient was a victim of a ‘medical accident’, then it will itself pay the compensation. The Commission follows the general law as to its manner of assessment of a patient’s harm.

(III) The hasty legislative sequel: the State ‘sharing’ the liability risks

The legislative changes of March 2002 sought to strike a balance between the interests of patients, of doctors and of institutional providers of health care, but the reaction of the insurance industry was dramatic. For while all persons and institutions who could be liable under the new provisions had to insure, some insurers left the French market and others refused to renew the cover for some half of private health care institutions and some public hospitals: there was a real likelihood that some hospitals and clinics would have to stop work for want of insurance cover.¹⁸² Further legislation was therefore introduced in Parliament later in 2002 to ‘reassure’ medical insurers and this passed into law on 30 December 2002, two days before some of the insurance coverage was due to end.¹⁸³ The effect of this new legislation was to transfer the liability for (p.155) compensation in three situations to the national compensation fund; first, liability for Creuzfeld-Jakob disease (CJD) transmitted to some 2,000 patients treated with human growth hormone (HGH) between 1973 and 1988;¹⁸⁴ secondly, liability for the intervention of medical practitioners ‘in exceptional circumstances’ (for example, at a roadside accident);¹⁸⁵ and, thirdly, liability for ‘nosocomial infections’ contracted in a health establishment, service or body (but apparently not in a private doctor’s surgery¹⁸⁶) where this causes an incapacity of 25 per cent, leaving only relatively minor cases to these bodies’ insurers.¹⁸⁷ This means that the national fund and the assurers share the cost of harm caused by nosocomial infections.

The first and third of these impact on liability for medical products. The first is an example of a particularly prominent case of the supply of a harmful product, the first civil case having recently succeeded against those bodies responsible for the supply of HGH in France,¹⁸⁸ proceedings in the criminal courts being still in progress.¹⁸⁹ Here, the financial responsibility for the consequences of the product were simply transferred from the supervisory body of this supply (the Association France-Hypophyse, subsequently dissolved) to the new national compensation fund, though this apparently leaves the possibility of claims being made against other persons potentially liable for the supply (notably, the Institut Pasteur and the hospitals providing the treatment). As regards liability for ‘nosocomial infections’, the December legislation transferred a proportion of the cost of the strict liability which the March legislation had imposed from the insurers of the institutional providers of health care to the national compensation fund. As I have explained, this may also have an effect on some cases of their liability for products.¹⁹⁰ For the national compensation fund is given a right of recourse against the providers of health care (and their insurers) only where that provider has committed a proven fault (une faute établie) and in particular breach of one of its duties imposed by the rules enacted to prevent nosocomial infection.¹⁹¹ To the extent, therefore, to which this applies to infections contracted by patients as a result of products supplied to them by these establishments, it changes the basis of their liability to a particular demanding degree of fault, un manquement caracterisé.¹⁹² As I have noted, producers and suppliers of medical products were included in the earlier requirement of insurance against liability and so also stand to benefit from this shift in the extent of liability by the State’s undertaking of the risk of harm for nosocomial infections.

Notes:

(¹) Above, pp. 22–3.

(²) I shall restrict services publics to this special French usage, using the English ‘public services’ in one of the other meanings which I have identified.

(³) Gaudemet, Droit administratif, Tome 1, 34 et seq. See also Chapus, Droit administratif général, Tome 1, 578 et seq.

(⁴) Brown and Bell, 131–4 .

(⁵) This means both that some services provided by private bodies may count as services publics and that certain services provided by public bodies may not count as services publics. Examples of the latter may be found in the management of public property known as the domaine privé (Chapus, Droit administratif général, Tome 1, 585–6) and the activities of entreprises publiques, such as Regie Renault.

(⁶) For criticism of this role: Rivero and Waline, Droit administratif, 164–9 .

(⁷) Named after Louis Rolland, these are a principle of continuity of the service public, its ‘mutability’ in the public interest and equality in its application to citizens: Moreau, Droit administratif 333 et seq. ; Chapus, Droit administratif général, Tome 1, 603 et seq.

(⁸) See the discussion in Chapus, Droit administratif général, Tome 1, 167 et seq. who also draws attention to the special privileges accorded to public bodies against the normal methods of the execution of judgments (voies d’exécution), the special prescription period for their debts (la prescription quadriennale) and the impossibility of recourse to arbitration.

(⁹) Above, p. 133.

(¹⁰) Above, p. 30.

(¹¹) A service public administratif need not even be provided by a public body (etablissement public), e.g. the activities of ordres professionnelles: Chapus, Droit administratif général, Tome 1, 537–40 .

(¹²) Chapus, ibid., 591 et seq.

(¹³) E.g. the leading case of TC 22 Jan. 1921, Bac d’Eloka, Leb. 91, D 1921.3.1 concl. Matter; Cf. CE Sec. 10 May 1974, Denoyez et Chorques, Leb. 274 (both ferry services).

(¹⁴) E.g. CE Ass. 16 Nov. 1956, Union syndicate des industries aéronautiques, Leb. 434, D 1956.759 concl. Laurent.

(¹⁵) TC 22 Feb. 1960, Soc. Pétronaphte, Leb. 857.

(¹⁶) Gaudemet, Droit administratif, Tome 1, 756 (‘assez empirique’).

(¹⁷) If the citizen is not yet a recipient of the service but wishes to be, he is termed a candidat. Notice that usager here is used in a different sense from usage in the context of liability for ‘public works’: cf. above, pp. 126–8.

(¹⁸) Cf. the former exception as regards PTT, the French telephone corporation which was classed as a service public administratif but whose customers received the service under contracts ‘with regulatory effects’: CE Sect. 29 Jun. 1979, Mme Bourgeois, Leb. 293. This was changed by the loi no. 90–568 of 2 Jul. 1990 arts. 25, 26 which placed the relationship between the ‘public operators’ of the telephone service in the private law domain.

(¹⁹) TC 28 Jun. 1965, Ruban c. Société de I’Autoroute Estérel-Côte d’Azur, Leb. 816.

(²⁰) Below, p. 151 et seq.

(²¹) Chapus, Droit administratif général, Tome 1, 554 .

(²²) Moreau, Droit administratif 343 and see CE 2 Oct. 1985, Jeissou, Leb. Tab. 544, AJDA 1986.1.38 concl. Jeanneney Where a private body provides a service public administratif and this takes the form of decisions (actes), these will be subject to control by the administrative courts under the law of excès de pouvoir: see, e.g., as regards the bodies regulating French professions (ordres professionnels): Rivero and Waline, Droit administratif 442 .

(²³) CE Sect. 10 Mar. 1978, Office public d’HLM de Nancy, Leb. 121. For ouvrage public more generally, see above, pp. 123–4.

(²⁴) TC 22 Apr. 1985, Maret, D. adm. 1985 no. 282.

(²⁵) Above, pp. 118–21.

(²⁶) CE 25 Apr. 1958, Barbaza, Leb. 228; CE 22 Jan. 1960, Gladieu, Leb. 52; TC 17 Oct. 1966, Veuve Canasse, Leb. 834. There are exceptions, e.g., a person who travels by train without a ticket belongs to private law even though there is no contract: TC 5 Dec. 1983, Niddam, Leb. 541.

(²⁷) Rivero and Waline, Droit administratif, 446 .

(²⁸) TC 11 Jul. 1933, Dame Mélinette, Leb. 1237.

(²⁹) Further exceptions exist in the case of harm caused by ‘decisions organising the service’ (‘actes d’organisation du service’) and where a body exercises distinctly public powers (‘prérogatives de puissance publique’): Chapus, Droit administratif général, Tome 1, 840 .

(³⁰) Below, pp. 137–9, 140–1.

(³¹) In the case of gas, the change was made by loi no. 2003–8 of 3 Jan. 2003 relative aux marchés du gaz et de I’electricité et au service public de I’energie, implementing Dir. 98/30/EC of 22 Jun. 1998 concerning common rules for the internal market of natural gas. In doing so, the French legislature specifically applied a reinforced set of obligations de services publics on all those operating in the French market: by loi no. 2003–8, art. 16.

(³²) Traditionally, the most important companies have been Cie générale des eaux (which as ‘Vivendi Water’ forms part of the Vivendi Universal group) and La Lyonnaise des Eaux.

(³³) Chapus, Droit administratif général, Tome 1, 641–2 who notes that sometimes the distribution of water is placed by a local authority in the hands of a private company by affermage.

(³⁴) Such a unilateral right of variation stems from the principle of the ‘adaptation or ‘mutability’ of the public service: Gaudemet, Droit administratif, 749–50 .

(³⁵) J.-P. Gridel, note to Angers 11 Mar. 1986, JCP 1987.II.20789.

(³⁶) E.g. Civ. (1) 26 May 1994, Bull. civ. I no. 190.

(³⁷) Paris 4 Jun. 1980, JCP 1980.II.19411 concl. Bernard.

(³⁸) Cf Anger 11 Mar. 1986, JCP 1987.II.20789 obs. Gridel.

(³⁹) Civ. (1) 26 Oct. 1964, Bull. civ. I no. 468.

(⁴⁰) Above, p. 71.

(⁴¹) Civ. (1) 9 Dec. 1986, JCP 1987.II.20790 obs. Gridel.

(⁴²) Chapus, Droit administratif général, Tome 2, 649 ; CE 13 Mar. 1959 Leb. 182; CE 22 Jan. 1960, Gladieu, Leb. 52.

(⁴³) So, for example, a workman brought in by a customer to repair an electrical installation (CE 14 Jun. 1961, Dame Bayer, Leb. 406) counts as a ‘third party’ as much as a mere passer-by injured when an escape of gas explodes (CE 22 Jan. 1960, Gladieu, Leb. 52).

(⁴⁴) CE 14 Jun. 1961, Dame Bayer, Leb. 406. On ‘public works’, see above, p. 121 et seq.

(⁴⁵) Civ.(1) 17 Nov. 1987 (unreported) pourvoi no. 86–12926 (legifrance).

(⁴⁶) Above, p. 126–8.

(⁴⁷) CE 14 Jun. 1961, Leb. 406.

(⁴⁸) Above, p. 128.

(⁴⁹) Above, p. 133.

(⁵⁰) Above, pp. 134–6.

(⁵¹) Above, p. 121 et seq.

(⁵²) But cf. below, pp. 523–7, esp. at p. 524.

(⁵³) Below, pp. 140–1 (rail).

(⁵⁴) Above, n. 13 (ferry services).

(⁵⁵) As regards air transport, liability is governed by international convention and in particular the Warsaw Convention of 12 October 1929, whose system was applied to internal carriage by air by the loi of 2 Mar. 1957. As regards carriage by sea, French law has taken its own position principally by the loi no. 66–420 of 18 Jun. 1966.

(⁵⁶) Above, pp. 60–1.

(⁵⁷) Below, pp. 140–1.

(⁵⁸) Art. 1784 C. civ.

(⁵⁹) Art. 103 C. com., Com. 25 Jan. 1954, GP 1954.1.423.

(⁶⁰) Art. 103 al. 3 C. com.

(⁶¹) Civ. 21 Nov. 1911, S 1912.1.73 note Lyon-Caen, D 1913.1.249 note Sarrut.

(⁶²) Above, p. 28.

(⁶³) Civ. (1) 27 Apr. 1976, JCP 1976.II.18477 note Rodière, RTDCiv. 1977.138 obs. Durry.

(⁶⁴) Civ. 6 Dec.1932…Civ. 24 May 1933, S 1934.1.81 note Esmein. The dependent may renounce the benefit of this stipulation and sue instead in delict: Com. 19 Jun. 1951, affaire Lamoricière, S 1952.1.89 note Nerson (claimants avoiding an exemption clause in the contract of carriage).

(⁶⁵) So accidents on station platforms do not concern the performance of the contract of carriage and therefore give rise only to liability in delict: Civ. (1) 7 Mar. 1989, D 1991.1 note Malaurie, RTDCiv. 1989.548 obs. Jourdain (art. 1384 al. 1 C. civ. applicable as gardien of the train).

(⁶⁶) The general law also applies to carriage in trams and by horse, both of which fall outside the categories of special regulation. Sometimes French administrative law has governed the liability of the provider of a public water transport service as in the famous case TC 22 Jan. 1921, Bac d’Eloka, Leb. 91, D 1921.3.1 concl. matter; cf. CE 26 Jul. 1930, Benoit, 840.

(⁶⁷) The first French railways were built and operated by private companies under ‘concessions’ granted by the State, which exercised control on the fares on the basis that the services constituted services publics: Chapus, Droit administratif général, Tome 1, 173 ; loi of 11 Jun. 1842; SNCF ‘Naissance des chemins de fer en France’, 〉http://www.sncf.com〈.

(⁶⁸) On nationalisation in 1938, SNCF was formed as a société d‘economie mixte, 51% of whose capital belonged to the State and the rest to the shareholders of the five former private rail companies, but in 1982 it became an ‘etablissement public à caractère industriel et commercial:’ SNCF ‘Création de la SNCF’ and ‘Création de l‘établissement public SNCF’ 〉http://www.sncf.com〈.

(⁶⁹) Ripert and Roublot, Traité de droit commercial, Tome 2, (14th. edn., LGDJ, Paris, 1994), by P. Delebecque and M. Germain, 781–2 .

(⁷⁰) Civ. 30 Jun. 1953, D 1953.642.

(⁷¹) G. Durry, obs. to Civ. (1) 26 Jan. 1971, RTDCiv. 1971.863.

(⁷²) E.g. CE 14 Mar. 1990, Mme Declerck, Leb. 965, CJEG 1990.217, concl. Daël, note D.D. (claimant injured riding a bicycle across a manual level crossing held to be a ‘user’ of the ouvrage public for which SNCF was responsible).

(⁷³) Above, pp. 124–9.

(⁷⁴) Le système de santé en France (2003) § 1.3 published at 〉http://www.sante.gouv.fr〈.

(⁷⁵) Ibid., §2.1 .

(⁷⁶) 80% of the population of ‘commercial employees’ are insured by the Régime général de la Sécurité sociale; other groups are covered by more specialised bodies, e.g. agricultural workers by the Mutualité sociale agricole: ibid.

(⁷⁷) Ibid.

(⁷⁸) Loi no. 2002–303 of 4 Mar. 2002 relative aux droits des malades et à la qualité du système de santé (‘loi of 4 Mar. 2002’) creating art. L 1142–1 C. santé pub.

(⁷⁹) Below, p. 143.

(⁸⁰) Below, p. 151.

(⁸¹) Loi of 4 Mar. 2002 creating art. L 1142–2 C. santé pub.; loi no. 2002–1577 of 30 Dec. 2002 relative à la responsabilité médicale, art. 1 (infections nosocomiales), below, pp. 154–5.

(⁸²) Civ. 20. May 1936, DP 1936.1.88, rapp. Josserand, concl. matter. Doctors working in either the public or private sectors have also been prosecuted for involuntary homicide or causing personal injuries but only those in the private sector (or their hospital employers) can be held liable in damages by the criminal courts to their patients present as parties civiles owing to the separation of jurisdictions: TC 14 Jan. 1935, S 1935.3.17 note Alibert (not in the medical context).

(⁸³) Civ. (1) 4 Jun. 1991, JCP 1991.II.21730 note Savatier, RTDCiv. 1992.123 , obs. Jourdain which also held that the employer’s liability excludes that of the doctor personally.

(⁸⁴) J. Penneau, ‘La réforme de la responsabilité médicale: responsabilité ou assurance’, RIDC 1990.525, 536 , who notes that doctors are also liable for any auxiliary staff who work under them, whether or not they are employed by the hospital; Malaurie, Aynès and Stoffel-Munck, Obligations, 472 .

(⁸⁵) Civ. 20. May 1936, DP 1936.1.88, rapp. Josserand, concl. matter. For a more recent example, see Civ. (1) 27 May 1998, Bull. civ. I no. 185.

(⁸⁶) Cf. Civ (1) 27 May 1998, Bull. civ. I no. 185 and Civ. (1) 13 May 1998, Bull. civ. I no. 174.

(⁸⁷) J. Penneau, op. cit. n. 84, 532.

(⁸⁸) Civ. (1) 29 May 1984, D 1985.281 note Bouvier.

(⁸⁹) Civ. (1) 27 May 1998, Bull. civ. I no. 187.

(⁹⁰) Civ. (1) 29 Jun. 1999, rapp. Sargot, JCP 1999.II.10138.

(⁹¹) Paris (1) 15 Jan. 1999, JCP 1999.II.10068 note Boy.

(⁹²) Boy, ibid., at 738 .

(⁹³) Where a patient was treated privately by a doctor in a public hospital, liability in the doctor is a matter for the ordinary courts, liability in the hospital or its auxiliary staff for the administrative courts: CE. 10 Oct. 1973, Mlle de Saint-Louvent, Leb. 556.

(⁹⁴) Vedel and Delvolvé, Droit administratif, Tome 1, 562–3 , above, pp. 31–2.

(⁹⁵) R. Chapus, Droit administratif général, Tome 1 (Montchrestien, Paris, 4th. edn., 1988) 811–12 .

(⁹⁶) CE 10 Apr. 1992, JCP 1992.II.79027 note Moreau, Leb. 1992 171, concl. Legal.

(⁹⁷) E.g. Civ. (1) 30 Oct. 1962, D 1963.57 note Esmein, JCP1962.II.12924 note Savatier, RTDCiv. 1963.329. obs. Tunc (patient injured when the step of an examining table gave way).

(⁹⁸) Civ. 27 May 1940 DC 1941.53, GP 1940.2.81 (lower court’s decision holding doctor liable as gardien of the X-rays quashed on the basis that a doctor’s liability to his or her patient was exclusively contractual). Cf. the position where the patient’s relatives sued where delict was allowed: Civ. (1) 1 Apr. 1968, D 1968.653, note Savatier, JCP 1968.II.15547 note Rabut (anaesthetic apparatus); Civ. (1) 25 May 1971, JCP 1971.IV.175 (doctor liable only if the injected agent was defective).

(⁹⁹) Viney and Jourdain, Conditions, 470–5 . At times the courts used factual presumptions of fault in this context, e.g. Civ. (1) 28 Jun. 1960, JCP 1960.II.11787 note Savatier, RTDCiv. 1961.112, obs . Tunc (presumption that the defective nature of medical apparatus was due to some fault in those who used it).

(¹⁰⁰) Rouen 7 Feb. 1984, DS 1985.IR 405 obs. Penneau. See also Seine 3 Mar. 1965, JCP 1966.II.14582 note Savatier (which imposed an obligation de résultat on the medical team collectively as to the safety of an anaesthetic machine for the benefit of the deceased patient’s relatives); Pontoise 28 Nov. 1986, D 1987.31 note Larroumet.

(¹⁰¹) Penneau, obs. DS 1985.IR. 405, 406.

(¹⁰²) Civ. (1) 9 Nov. 1999, Bull. civ. I no. 1; D 2002.117 note Jourdain (no recovery on the facts as the equipment in question (an examination table) had not been shown to be causally related to the patient’s harm).

(¹⁰³) A. de Laubadère, J.-C. Venezia and Y. Gaudemet, Traité de droit administratif, Tome 1 (LGDJ, Paris, 10th. edn., 1988) 778 .

(¹⁰⁴) R. Chapus, Droit administratif général, Tome 1, (4th. edn., 1988) 812 .

(¹⁰⁵) CE 1 Mar. 1989, Epoux Peyres, Leb. 65.

(¹⁰⁶) CE 4 Mar. 1988, Godoy, GP 1988.1.Pan.Jur.226.

(¹⁰⁷) In the case of protheses, the courts accepted that, for example, a dentist’s liability for diagnosis or fitting was governed by an obligation de moyens, but its manufacture an obligation de résultat: Paris 8 Feb. 1991, JCP 1992.II.21788 note Méméteau; Poitiers 8 Apr. 1992, DS 1993.Somm. 27; Civ. (1) 29 Oct. 1985, Bull. civ. I no. 273.

(¹⁰⁸) Civ. (1) 23 May 1973, JCP 1975.II.17955 note Savatier, GP 1973.2.885 note Doll. See similarly Civ. 6 Mar. 1945, D 1945.J.217; Civ. (1) 29 Jun. 1977, JCP 1977.IV.225; Civ. (2) 30 Jun. 1976, JCP 1979.II.19038.

(¹⁰⁹) On the patient’s claim against the drug’s manufacturer, see below, p. 147.

(¹¹⁰) Civ. (1) 4 Feb. 1959, JCP 1959.II.11046 note Savatier, D 1959.153 note Esmein.

(¹¹¹) Above, p. 69 et seq.

(¹¹²) Chapus, Droit administratif général, (op. cit. n. 104) 807–808 .

(¹¹³) CE Ass. 7 Mar. 1958, Dejous, Leb. 153, AJDA 1958.2.220, chron. Fournier et Combarnous, RDP 1958.1087 concl. B. Jouvin. By loi no. 64–643 of 1 Jul. 1964, as amended by loi no. 75–401 of 26 May 1975 a system of State liability for vaccinations in public hospitals was created: P.-J. Doll, ‘Des responsabilités en matière de vaccinations obligatoires’, JCP 1975.I.2736.

(¹¹⁴) CE 22 Dec. 1976, Dame Derridj, Leb. 576, JCP 1978.II.18792 note J.-M. Auby.

(¹¹⁵) CE Ass 9 Apr. 1993, Bianchi, JCP 1993.II.22601 note Moreau, AJDA 1993.349 note Mangüé and Touvet. Cf. the earlier decision in CAA Lyon 21 Dec. 1990, Gomez, AJDA 1993.349.

(¹¹⁶) Moreau, note, JCP 1993.II.22601.

(¹¹⁷) E.g. liability for ‘dangerous things’ or for the infliction of an ‘abnormal and direct loss’: see Moreau JCP 1993.II.22601.

(¹¹⁸) Mangüé and Touvet, op. cit. n. 115, 351 .

(¹¹⁹) Civ. (1) 8 Apr. 1986, arrêt Thorens, JCP 1987.II.20721 note Viala and Viandier, RTDCiv. 1987.777, obs . Huet (pourvoi en cassation against Paris 15 Dec. 1983, D 1985.228 note Penneau). See also Paris 4 Jul. 1970, D 1971.73 note Plat and Duneau; Rouen 14. Feb. 1979, affaire Nimaol, JCP 1980.II.19360 note Boniet, D 1979 IR 25 obs. Larroumet (liability for contractual fault) and J. Huet, ‘Le paradoxe des médicaments et les risques de développement (question suscitée par des décisions de jurisprudence récentes et quelques articles de presse: la responsabilité pharmaceutique estelle une responsabilité pour faute?)’ D 1987 Chron. 73 .

(¹²⁰) Civ. (2) 30 Jun. 1976, JCP 1979.II.19038 (manufacturer of an elderly ampoule held not liable under art. 1384 al. 1 C. civ. as it did not possess ‘the powers which characterise la garde’ of the ampoules).

(¹²¹) Cf. above, p. 51.

(¹²²) Nanterre 12 Dec. 1985, extracts reported D Chron. 1987.78–79.

(¹²³) Paris 4. Jul. 1970, D 1971.73 note Plat and Duneau.

(¹²⁴) Nanterre 12 Dec. 1985, extracts reported D Chron.1987.78.

(¹²⁵) Paris 4 Jul. 1970, D 1971.73 note Plat and Duneau; Civ. (1) 23 May 1973, JCP 1975.II.17955 note Savatier, GP 1973.2.885 note Doll; Civ. (1) 8 Apr. 1986, arrêt Thorens, cit.

(¹²⁶) Pau 12 Mar. 1958, S 1958.397 note F. G., GP 1958.1.322.

(¹²⁷) For other cases concerning liability for warnings in the pharmaceutical context, see Civ. (2) 23 Feb. 1983, D 1983 IR 497 obs. Penneau (manufacturer gave sufficiently detailed information as to its product implanted by a doctor); Nanterre 12 Dec. 1985, extracts reported D Chron.1987.78–79 (manufacturer liable for failing to inform medical profession of risks to teeth of antibiotic); Rouen 14 Feb.1979, JCP 1980.II.19360 note P. Boniet, D 1979.IR.25 note Larroumet (information insufficiently brought to doctors’ attention); Paris 20 Jun. 1963, GP 1963.2.319, D 1964.30 (criminal court found manufacturer of a concentrated antiseptic supplied neat by a pharmacist and applied neat by its customer had clearly and explicitly attached a warning against its undiluted use).

(¹²⁸) Civ. (1) 3 Mar. 1998, Bull. civ. I, no. 95, JCP 1998.II.10049 rapp. P. Sargos and see below, pp. 455–7.

(¹²⁹) Art. L. 4211–1 et seq. C. santé publ.

(¹³⁰) B. Harichaux de Tourdonnet, ‘Santé, Responsabilité du pharmacien, Pharmacien-fabricant, Pharmacien d’officine, Laboratoire d’analyse de biologie médicale’, in Jur.-Cl. Responsabilité civile, Arts. 1382 à 1386, (Eds. Techniques, Paris), Fasc. 442, 24–25 .

(¹³¹) Ibid., 10 .

(¹³²) Paris 4 Jul. 1970, D 1971.73 note Plat et Duneau.

(¹³³) art. R. 5015–48 C. santé publ.; Cf Agen 3 Apr. 1950, GP 1950.2.59 (pharmacist not guilty of criminal fault as user’s reaction was ‘totally inexplicable and unforeseeable’).

(¹³⁴) Y. Lambert-Faivre, Le droit du dommage corporel, (Dalloz, Paris, 1st. edn., 1990), 440 . The main legislation was the loi no. 52–854 of 21 Jul.1952.

(¹³⁵) Lambert-Faivre, ibid., 441 .

(¹³⁶) Above, p. 10. Loi no. 93–5 of 4 Jan. 1993; loi no. 98–535 of 1 Jul. 1998.

(¹³⁷) Below, pp. 315–19, 324.

(¹³⁸) Below, pp. 394–401.

(¹³⁹) R. Savatier, note to Civ. 17 Dec. 1954, JCP 1955.II.8490.

(¹⁴⁰) Civ. 17 Dec. 1954, JCP 1955.II.8490, note Savatier, GP 1955.1.54, D 1955.269 note Rodière.

(¹⁴¹) Cf. above, pp. 134–5.

(¹⁴²) Savatier, note JCP 1955.II.8490.

(¹⁴³) Civ. (1) 12 Apr. 1995, Dupuy, Martial, JCP 1995.II.22467 note Jourdain . Cf. the earlier Paris 1 Jul. 1991, JCP 1991.II.21762 note Harichaux.

(¹⁴⁴) In 2001, the Cour de cassation extended the benefit of this contractual liability to a deceased patient’s relatives on the basis that third parties to contracts may properly rely on a breach of contract of one of the parties where it causes them harm: Civ. (1) 13 Feb. 2001, Bull. civ. I no. 35.

(¹⁴⁵) Civ. (1) 12 Apr. 1995, affaire Dupuy, JCP 1995.II.22467 note Jourdain.

(¹⁴⁶) CE Ass. 26 May 1995, Pavan, N’Guyen, Jouan, Leb. 221, AJDA 1995.577–78, AJDA 1995.508 note Stahl and Chavaux, JCP 1995.II.22468 note Moreau. See also M.-A. Peano and D. Peano ‘Les centres de transfusion sanguine devant le juge judiciaire et le juge administratif’ (1995) Resp. civ. et assur. no. 31, 3 ; J.-S. Bergé, ‘Risque et faute dans la contamination transfusionelle’ GP 1996.2.737.

(¹⁴⁷) Peano and Peano, ibid., 5 .

(¹⁴⁸) CE Ass. 26 May 1995, N’Guyen, cit.

(¹⁴⁹) CE Ass. 26 May 1995, Pavan, cit.

(¹⁵⁰) Below, pp. 458–9.

(¹⁵¹) Commission v France, Case C-52/00 of 25 Apr. 2002, [2002] I-3827, paras. 36–47; loi of 9 Dec. 2004, art. 29, below, p. 459.

(¹⁵²) Loi no. 98–535 of 1 Jul. 1998, art. 18.

(¹⁵³) Art. 1223–1 C. santé pub.

(¹⁵⁴) CE 27 Oct. 2000, Torrant, Leb. 147.

(¹⁵⁵) Loi no. 2002–303 of 4 Mar. 2002 relative aux droits des malades et à la qualité du système du santé, (‘loi no. 2002–303’) art. 98 creating new tit. IV of book 1 of the legislative part of the C. santé pub.

(¹⁵⁶) Art. 1142–2 C. santé pub. See P. Mistretta, ‘La loi no. 2002–303 du 4 mars 2002 relative aux droits des malades et à la qualité du système du santé, Réflexions critiques sur un droit en pleine mutation’, JCP 2002.I.141 ; P. Sargos, ‘Le nouveau régime juridique des infections nosocomiales, loi no. 2002–303 du 4 mars 2002’ JCP 2002 Actualité, 1117 ; Y. Lambert-Faivre, ‘La loi no. 2002–303 of 4 Mar. 2002 relative aux droits des malades et à la qualité du système du santé III—Lindemnisation des accidents médicaux’ D 2002 Chron. 1367 .

(¹⁵⁷) Art. L. 1142–1 al. II C. santé pub.

(¹⁵⁸) Loi no 2002–303, art. 102 and see Ass. Nat. No. 3688, Rapport d’information by C. Evin, B. Charles et J.-J. Denis, Troisième partie, 39 .

(¹⁵⁹) Art. L. 1142–1 al. 1 C. santé pub.

(¹⁶⁰) Ass. Nat. No. 3263, Rapport (28 Sept. 2001) by C. Evin, B. Charles et J.-J. Denis ; and see Sén., (2001–2002) no. 174, Rapport by F. Giraud, G. Dériot and J.-L. Lorrain, p. 221; Sén. No. 175 , Avis by P. Fauchon, 14; Ass. Nat. No. 3688 , Rapport d’information by C. Evin, B. Charles et J.-J. Denis, Troisième partie .

(¹⁶¹) Ass. Nat. Déb. (2nd séance of 2 Oct. 2001), J.O. Rép. f., 5322.

(¹⁶²) New art. L. 1142–28 C. santé publ.

(¹⁶³) Mistretta, op. cit. n. 156, 1080.

(¹⁶⁴) Above, pp. 143, 145–6.

(¹⁶⁵) Ass. Nat. Texte No. 705 (4 Oct. 200 1), projet de loi, draft art. L. 1142–1 al. 1 C. santé pub.; Ass. Nat. No. 3263, Rapport, 3–4 .

(¹⁶⁶) Sargos, op. cit. n. 156, 1118 (proven fault) ; Mistretta, op. cit. n. 156, 1080–1 (presumed as well as proven fault) ; Lambert-Faivre, op. cit. n. 156, D 2002 Chron. 1367 at 1368 (loi confirms previous ‘remarkable developments’ of notion of fault).

(¹⁶⁷) Art. L. 1142–1 al. 1 C. santé pub.

(¹⁶⁸) E.g. Ass. Nat. No. 3263, Rapport, 22–3.

(¹⁶⁹) Below, p. 459.

(¹⁷⁰) Lambert-Faivre, op. cit. n. 156, D 2002 Chron 1367 at 1368.

(¹⁷¹) Above, pp. 144–5.

(¹⁷²) Art. L. 1142–1 al. 1 C. santé pub. in fine.

(¹⁷³) Sargos, op. cit. n. 156, 1117–8. The category is therefore wider than ‘iatrogenic conditions’ which are any conditions directly related to health care. Cf. the definitions given in Sén. No. 174, Rapport, 229.

(¹⁷⁴) Sén. No. 174, Rapport, 224.

(¹⁷⁵) Below, p. 523.

(¹⁷⁶) Sénat, No. 174, Rapport, 223.

(¹⁷⁷) Art. 1142–1-II C. santé pub.

(¹⁷⁸) Ibid.

(¹⁷⁹) The provisions are contained in new arts. L 1142–4—1142–24 C. santé pub.

(¹⁸⁰) Ass. Nat. No. 3688, Rapport d’information, 34 et seq. describes this new procedure .

(¹⁸¹) New art. L. 1142–15.3 C santé pub.

(¹⁸²) Sén. No. 33, Proposition de loi relative à la responsabilité civil médicale, Exposé des motifs (24 Oct. 2002) .

(¹⁸³) Loi no. 2002–1577 of 30 Dec. 2002 relative à la responsabilité civile médicale on which see P. Mistretta, ‘La Loi no. 2002–1577 of 30 Dec. 2002 relative à la responsabilité civile médicale. Premiers correctifs de la loi no. 2002–303 du 4 mars 2002’ JCP 2003 Actualité 165 .

(¹⁸⁴) New art. L. 1142–22 al. 2 C. santé pub.

(¹⁸⁵) New art. L. 1142–1–1 2º C. santé pub.

(¹⁸⁶) Mistretta, op. cit. n. 183, JCP 2003 Actualité 165.

(¹⁸⁷) New art. 1142–1–1 1º C. santé pub.

(¹⁸⁸) TGI Montpellier 9 Jul. 2002 No. 02/00565 reported 〉http://www.editions-legislatives.fr/aj/actualites/〈.

(¹⁸⁹) The bodies responsible for the supply of HGH in France were the Association France-Hypophyse and the Institut Pasteur. In April 2004, the dossier was still before the juge d’instructiom Le Quotidien du médecin, 28 Apr. 2004.

(¹⁹⁰) Above, p. 153.

(¹⁹¹) New art. L 1142–17 and L. 1142–21 C. santé pub.

(¹⁹²) Mistretta, op. cit. n. 183, JCP 2003 Actualité 165.