In short
In a private hospital, the contract and the responsibility of the institution are spoken of. It is not the administrative path of a public hospital.
The contract and the responsibility of the institution are spoken of. It is not the administrative path of a public hospital.
The path of compensation against a public hospital is in a separate writing.
The hospital contract may open a consumer face.
Related writings: an aesthetic dispute.
The first separation in a private-hospital file: the need for treatment and the legal examination
If it is thought that damage arose after an intervention made in a private hospital, the priority is to receive care suitable to the existing health problem. In an emergency sign, an infection, bleeding or a loss of function, it is not correct to delay the treatment because of the dispute with the hospital. If an assessment needs to be taken at another establishment, the earlier documents should be taken along, and it should be provided that the new findings are put on the record. The continuation of the treatment is a health need independent of the process of gathering evidence.
The legal examination is more detailed than the sentence "I paid a fee and the result was bad". Which service was undertaken, the conformity of the medical practice to the standard, the organisational obligations of the hospital, the process of information, the damage and the causal link are assessed together. The status of a private hospital does not mean that every unfavourable result will be compensated. The private-law relation the establishment formed with the patient differentiates the path of application from a public hospital.
This text is general information. Without the health position, the relation of the institution and the physician, and the type of the claim being seen, a definite assessment of responsibility or of the result cannot be made.
The physician's practice and the organisation of the hospital should be separated
A medical service is team work most of the time. While the decisions of diagnosis and of treatment are given by the physician, the laboratory, imaging, the operating theatre, nursing, sterilisation, the supply of medicine and the system of emergency intervention rest on the organisation of the hospital. In a claim of damage, focusing only on the last act of one person may make the institutional side of the event invisible. Conversely, counting every clinical decision automatically as a lack of organisation of the hospital is not correct either.
In the examination, the possible areas of responsibility may be separated like this:
- The conformity of the decision of diagnosis and of treatment to the professional standard
- The selection, the coordination and the supervision of the health personnel
- The safety of the device, the material and the medicine
- The control of infection and the order of the operating theatre
- The notification of critical test results
- The organisation of an emergency and of a referral
- The records being kept complete, correct and accessible
Each heading may require a different document and expertise. The general frame of the medical standard is taken up in the content what is medical malpractice?. The form of the physician's contract with the hospital is important. The integrity of the service the patient saw from outside, the duties the establishment undertook and the actual organisation are included in the assessment as well.
How are an unfavourable result, a complication and fault separated?
Taking a paid service in a private hospital does not give rise to a guarantee of the result. Surgery, drug treatment or diagnostic interventions may carry acceptable risks. A complication is an unwanted result that may arise even though the practice was careful. The risk being a known complication does not remove the obligations of correct preparation, of technical practice, of noticing it early and of suitable management.
Only "a complication developed" being written in the discharge summary may not be a sufficient technical explanation. The type of the risk, the factors particular to the patient, when it was noticed and which intervention was made are examined from the records. If the problem was recognised in time and managed with the accepted method, the assessment of fault may differ. If the signs were ignored, or the necessary intervention was delayed, the management of the complication is discussed separately.
The criteria of this separation are taken up in detail in the content is it a complication or a medical error?. The legal assessment rests not on the weight of the result, but on the standard of behaviour expected in the concrete conditions.
The medical records and the commercial documents should be taken together
In a private-hospital file, both the clinical and the contractual records matter. The patient-admission form, the package of the service or of the operation, the documents of price and of payment, the invoice, the records about the choice of the physician, the approvals of an additional transaction and the correspondence may show which service the establishment undertook. These do not take the place of the medical file. They explain the scope of the relation.
On the clinical side, these documents should be taken as a whole as far as possible:
- Records of examination and of admission
- The originals of the test results and of the images
- Notes of consultation and of referral
- Forms of the operation and of the anaesthesia
- Charts of nursing observation and of the administration of medicine
- Documents of consent and of information
- Records of discharge, of follow-up and of a new admission
The discharge summary alone may not contain the detailed information of time and of practice. The documents should be asked for with a written request. The list of delivery should be kept. The parts that are seen as missing should be requested separately. The guide requesting the patient file presents practical information about the scope of the records.
Information in a private hospital is also different from a guarantee of the result
The language of promotion or of the meeting of the private hospital may form particular expectations in the patient. Information in a medical service requires that the realistically expected benefit, the important risks, the alternatives and the process of recovery be explained in an understandable form. Expressions such as "there is no risk", "a definite result" or "you will certainly recover in a short time" may not fit with medical uncertainty. The messages of promotion, the notes of the meeting and the consent form may be examined together.
A signed form does not remove a technical fault, and it does not prove automatically that every risk was explained sufficiently. Whether the form is particular to the transaction, when it was taken, and whether the patient was given an opportunity to ask questions, are important. The details of the subject are in the writing what is informed consent?.
The patient choosing a particular physician, or a more expensive package, does not mean that they accepted all the risks either. On the other side, the expected aesthetic or functional result not fitting the personal expectation is not by itself proof of fault. The service that was undertaken, the medical reality and the actual result are compared with concrete documents.
How should a second opinion and an expert assessment be used?
A second opinion should be taken first in order to plan the treatment that continues. Instead of asking the new health worker for a document that accuses the earlier institution, having the current findings, the necessary treatment and the prognosis put on the record provides a more reliable approach. If the second physician has not seen the first records, it cannot be expected that they make a comparative assessment of fault.
In the legal technical examination, the relevant fields of expertise should be determined. A surgical transaction, anaesthesia, infection, radiology or the administration of a medicine may require the opinions of different experts in the same file. Not only the sentence of the result of the report, but which records and which scientific criterion it rests on, is important.
An expert report taken by the court is assessed together with the other evidence. If the report rested on a missing document, did not include the relevant field of expertise, or built the chronology of the event wrongly, these points may be made the subject of an objection in a concrete form. Only saying "we do not accept the report" does not show the technical lack.
The paths of a complaint, of a criminal case and of compensation are different
Making an internal application to the private hospital may provide that the event is explained, that a missing document is completed, or that an administrative examination is made. The channels of patient rights, and the applications made to the health administration, carry a purpose of supervision. A professional examination may assess the health worker's compliance with the rules of the profession. The criminal process is directed at the statutory elements of the offence. A claim of compensation aims at the damage being made good.
These paths do not take one another's place. The complaint being accepted is not an automatic decision to pay compensation. The complaint being refused does not remove the private-law claim in every case either. The process of a complaint about a physician explains the purposes of the application and the preparation of the evidence in detail.
In parallel applications, the dates of the event and the basic account should be kept consistent. If it is claimed in one petition that the transaction was not made at all, and in the other that it was made wrongly, an unexplained contradiction may weaken reliability. Even if the legal result each authority wants is different, the account of the material event should rest on the documents.
The private-law path and the conditions of procedure
The relation between the private hospital and the patient may intersect with legal frames such as a contract, a duty-of-care relation similar to a mandate, a consumer transaction and a tort. Which basis will come forward is determined according to the nature of the service, the parties and the claim. The role of the hospital, of the physician, of the laboratory or of the supplier in the event should be built separately. More than one possible responsible person being found does not mean that all of them are responsible for the same behaviour and at the same rate.
Whether there is compulsory mediation before the action, or another condition of procedure, should be checked according to the classification of the dispute and the current regulations. Seeing a health harm only as consumer dissatisfaction, and reducing it only to the heading of a medical fault, may both be incomplete. The type of the claim and the competent authority should be determined at the start.
The administrative path, which is different for public hospitals, is explained for comparison in the content the path of compensation in a public hospital. In a private-hospital file, turning by mistake to the path of an administrative action, or building a private-law logic directly in a public-hospital file, may create problems of the period and of jurisdiction.
The items of damage and the causal link should be documented
The fee of additional treatment that is claimed to have been paid in the private hospital, the expenses of medicine and of transport, the loss of income, the need for care and the effect of a lasting function may form headings of material damage according to the file. A non-pecuniary effect may be assessed according to the weight of the event as well. Invoices and receipts, records of inability to work, documents of income and health reports should be kept in order. The connection of each payment with the event that is claimed should be shown.
Beside the existence of the damage, a causal link is needed. The natural course of the underlying illness, the risks particular to the patient and the later decisions of treatment may have contributed to the result. Whether the same damage would have arisen if the claimed lack of organisation or of practice had not existed is assessed by experts. Uncertainty cannot be turned automatically into a definite result in favour of the patient or of the establishment.
It is important that the patient continue the reasonable treatment and take the steps that prevent the damage from increasing. If there is a delay because of financial impossibility, a problem of access, or an earlier traumatic experience, the conditions of the event are examined separately. The calculation of the damage is not made detached from the real conditions of life.
Periods and competence in the context of Ankara
In a private-health dispute, a limitation period or a period that extinguishes the right may change according to the legal nature of the claim and the dates of learning. The processes of a complaint and of a criminal case may be subject to different periods. The dates of the treatment, of the discharge, of the damage being noticed, of the second diagnosis, of the request for the document and of the hospital's answer should be kept in a calendar of the file. Making an unplanned application close to the end of the period may lead to the technical examination and the conditions of procedure staying incomplete.
For private hospitals that are in Ankara, the standard of medical care rests on the scientific and legal frame across the country. When the competent authority is determined, the place of the hospital, the patient's settlement, the contract and the provisions of procedure may be effective. It cannot be assumed that being in Çankaya or in another district changes the substance of the responsibility. The element of place is important more for competence and for practical follow-up.
The density of the file, the process of the expert and the time of service may change. For this reason expressions such as "a case takes this long in Ankara" or "a private hospital certainly settles" are not reliable. The preparation being orderly may reduce unnecessary delays. It does not provide a guarantee of the result and of the period.
A measured checklist for the start
In a suspicion of a medical error in a private hospital, this order may be applied: securing the health, asking in writing for all the medical and financial documents, building the chronology of the event, separating the physician's practice and the organisation of the hospital, assessing the headings of the complication and of consent, documenting the damage, and choosing the suitable path of application. Communication with the institution should be written, calm and concrete.
The complexity of the medical event prevents a definite judgment being built in the first assessment most of the time. The explanation of the hospital is not a final result by itself. The patient's strong opinion is not proof of a technical fault either. The examination of the relevant expertise and the legal classification should be conducted together.
Mediation on the line of the consumer court is in mediation in a malpractice action. The physician's policy is in the writing compulsory professional liability insurance. The upper frame is on the page health law. Every dispute is read separately with the contract, the record and the current legislation.
Where the private-hospital record is read from
A private-hospital file is read from the contract, the record and the type of the institution. The administrative path of a public hospital is not put in the place of this file. An amount is not written.
The office in Çankaya does not choose the authority the file will go to.
Conclusion
This writing is for general information. The document, the period and the procedure of the concrete event should be read separately. There is no promise of a result by heart.