Medical malpractice claims arising from university hospitals in Turkey involve intricate legal issues, as these institutions serve both as healthcare providers and centers for medical education. Understanding the liability framework for medical errors in university hospital settings is crucial for both patients and healthcare professionals. This article provides a comprehensive overview of the legal responsibilities, the types of compensation claims available, and the procedural steps involved in pursuing such claims under Turkish law.
Introduction
University hospitals hold a unique place within the Turkish healthcare system, functioning as both key providers of medical services and as educational institutions for future healthcare professionals. While their dual role supports the advancement of medical science and public health, it also introduces complexities in legal accountability, especially in cases of medical malpractice. Patients who experience harm due to errors in diagnosis, treatment, or care at university hospitals have specific legal avenues to seek compensation. This article aims to clarify the liability structure for medical malpractice in these institutions and guide individuals through the process of asserting their rights.
Legal Status of University Hospitals in Turkey
State vs. Foundation University Hospitals
University hospitals in Turkey are categorized as either state (public) university hospitals or foundation (private) university hospitals, each subject to distinct legal frameworks:
- State University Hospitals:
These operate under the direct oversight of the state, with healthcare professionals holding public servant status. Legal responsibility for damages resulting from medical malpractice is attributed to the hospital administration, not directly to individual physicians.
- Foundation University Hospitals:
While seemingly private, foundation university hospitals are considered public legal entities by law. They are subject to both the regulations governing private healthcare institutions and administrative law provisions due to their public service nature. As a result, liability for malpractice also rests with the institution rather than individual staff members.
Example
A patient treated at a foundation university hospital who suffers harm due to a surgical error would pursue a compensation claim against the institution, not the individual surgeon, in administrative courts.
The Legal Relationship Between Patients and University Hospitals
The Nature of Legal Engagement
- Patient vs. Hospital:
The relationship is not based on a direct contract with the physician. Instead, treatment is provided under the institutional framework, making the university (or its administrative body) liable for any harm due to medical negligence.
- Patient vs. Physician:
Although the physician delivers medical care, legal responsibility for malpractice is assumed by the hospital administration. The institution may, in turn, seek recourse against the physician if their personal fault is established.
Administrative Liability
According to Article 129 of the Turkish Constitution, compensation claims for damages caused by public servants during the performance of their duties must be directed against the relevant administrative authority, not against the individual.
Case Analysis
If a radiological misdiagnosis at a university hospital leads to delayed treatment and worsened health for a patient, the patient can initiate a compensation claim against the hospital's governing university rather than the radiologist.
Grounds for Liability: Fault and Strict Liability
Service Fault in University Hospitals
Liability arises when the hospital fails in its duty to provide timely, adequate, and competent healthcare services. This may include:
- Delays in treatment
- Failure to inform the patient of risks
- Inadequate medical intervention or aftercare
Strict (Objective) Liability
There are instances where the hospital may be held liable even in the absence of fault (intent or negligence), particularly under the “risk principle.” Extraordinary or unavoidable harm during medical procedures may give rise to compensation obligations.
Example
A rare but serious allergic reaction to a standard medication, not previously known to the hospital, could still result in liability under strict liability principles if the harm was exceptional and directly related to the hospital's activities.
Factors That Reduce or Eliminate Liability
Situations that may lessen or remove the hospital's responsibility include:
- Force majeure (unforeseeable events)
- Fault of a third party
- The patient's own contributory negligence (such as failing to follow medical advice)
Types of Compensation Claims Against University Hospitals
Material Damages (Pecuniary Compensation)
Claims may cover:
- Medical expenses relating to corrective treatment
- Loss of income due to incapacity
- Funeral and burial costs in the event of death
- Loss of future support for dependents of a deceased patient
Example
A patient who becomes permanently disabled due to a surgical error can claim compensation for ongoing medical needs and loss of earning capacity.
Non-Pecuniary Damages (Moral Compensation)
These claims address emotional distress, pain, and suffering experienced by the patient or, in fatal cases, by the patient's family. The court determines the appropriate amount based on the severity and circumstances of the harm.
Legal Procedure for Medical Malpractice Claims
Mandatory Administrative Application
Before filing a lawsuit, the claimant must apply to the relevant university rectorate within:
- One year from the date the harm was discovered
- No more than five years from the date of the incident
If the administration rejects the application or fails to respond within 30 days, the claimant may proceed to court.
Litigation in Administrative Courts
- Jurisdiction:
Only administrative courts are competent to hear these cases. Filing in civil courts will result in dismissal due to lack of jurisdiction.
- Parties to the Lawsuit:
The claim must be directed against the university (as the administrative entity), not individual healthcare professionals.
Burden of Proof
- The claimant must demonstrate that the hospital's actions or omissions constituted a service fault or that extraordinary harm occurred during treatment.
- The hospital may counter by proving it fulfilled its obligations or that the harm resulted from an external cause.
- Expert medical opinions and documented medical records are essential in establishing the facts.
Statute of Limitations
- Lawsuits must be filed within 60 days of receiving the administrative decision or after the expiration of the 30-day response period.
Practical Information for Patients and Families
- Identify the Responsible Entity:
Claims must be against the university's administrative body, not against individual doctors or nurses. - Observe Time Limits:
Missing application or litigation deadlines may result in loss of rights. - Document Everything:
Collect all medical records, correspondence, and receipts related to your case. - Seek Expert Reports:
Medical expert evaluations are crucial for substantiating claims. - Compensation Rights:
- Direct victims may claim if alive
- In fatal cases, close relatives can seek compensation
Conclusion
The legal framework for medical malpractice claims in university hospitals in Turkey is designed to balance the rights of patients with the operational realities of large, complex healthcare institutions. By channeling liability through the hospital administration rather than individual practitioners, the system provides an organized and equitable mechanism for addressing harm. Patients and their families should be aware of the specific procedures and deadlines involved in asserting compensation claims to avoid loss of rights. Legal counsel with experience in healthcare law can be invaluable in navigating these complexities and ensuring claims are properly presented.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
