Recent Federal Supreme Court judgment - Establishing a high bar for proving medical negligence
Dispute Resolution / UAE
In a recent medical negligence case, the Federal Supreme Court issued a ruling in Appeals no. 479, 592, 597 of 2024 which highlighted the importance of adhering to medical standards and underscored the legal responsibilities of healthcare providers.
Law Update: Issue 375 – Financial Services Focus
Ammar Haykal Partner, Head of Office – Northern Emirates
In a recent medical negligence case, the Federal Supreme Court issued a ruling in Appeals no. 479, 592, 597 of 2024 which highlighted the importance of adhering to medical standards and underscored the legal responsibilities of healthcare providers. The court held that in cases involving multiple accused parties and to establish a conviction in medical malpractice, the court must establish a clear and direct causal link between the medical professionals' actions and the harm caused.
This new ruling marks a significant development in the court’s approach to allocating liability in cases of negligence with multiple accused parties and highlights the legal standards required to establish medical malpractice. The judgment raises the standard of judicial oversight and legal analysis. It is a judgment that will prove particularly important to medical practitioners, as well as lawyers specialising in negligence cases more generally.
The question of shared liability for multiple parties in negligent acts is governed by Article 291 of the Civil Transactions Law Federal Law No. (5) of 1985, which provides that when there are multiple parties to a negligent act, each one of those parties is liable for their share in the act and the judge may at his discretion, choose to either assign liability equally between the parties, or assign liability jointly and severally.
The allocation of liability will be determined based on the facts of the case and the evidence provided, the decision is still at the discretion of the judge regardless of the identified share of each of the parties.
A doctor, who was party to the original case, erroneously administered an iron infusion to the pregnant wife of the applicant based on an incorrect diagnosis which led to the death of the woman’s foetus. The Supreme Medical Liability Committee concluded that the supervising doctors committed serious medical errors, including:
1- Failure to diagnose or delayed diagnosis. 2- Unjustified delay in treatment. 3- Lack of informed consent regarding treatment risks. 4- Poor medical documentation. 5- Gross ignorance of standard medical practices.
On appeal, the Court found the doctors (the defendants) involved in this case criminally liable for manslaughter pursuant to Federal Decree-Law No. 4 of 2016. This law limits criminal liability to serious medical errors as determined by the Medical Committee. The Court found the defendants guilty of medical malpractice and sentenced them to pay the "blood money" (compensation) to the family of the deceased foetus. In addition to the blood money of AED 200,000, the Court also fined each of the accused AED 10,000. The court also rejected the defendant’s request to summon additional medical experts for questioning, stating that the existing report was sufficient for determining the facts of the case.
Three of the accused doctors appealed further to the Federal Supreme Court, which disagreed with the primary court’s judgment, stating that the judgment is flawed as it failed to clearly define gross medical negligence, did not sufficiently explain how the defendants are liable, and relied solely on a medical committee’s report without proper legal analysis. It also did not establish the specific negligence of each defendant or their role in the foetus’s death, making it incomplete in determining criminal liability under the law. The Court overturned the previous judgment and remanded the case back to the appellate court for retrial before a different panel.
This new ruling marks a significant development in the court’s approach to allocating liability in cases of negligence with multiple accused parties and highlights the legal standards required to establish medical malpractice.
The Federal Supreme Court did not deny the appellant’s culpability and involvement in the death of the foetus. Its first point of disagreement with the previous Courts decision was their failure to properly define gross medical negligence in relation to each of the accused. Under Article 5 of Cabinet Resolution No. 40 of 2019 concerning the Executive Regulations of Federal Decree-Law No. 40 of 2016 concerning Medical Liability, gross medical malpractice will only occur if it leads to the death of a person or a foetus and satisfies any one of the criteria set out in the provision. The Federal Supreme Court was not satisfied that the Court had sufficiently explained how each of the defendants satisfied this legal threshold of gross medical negligence, nor did the Court provide any explanation as to what a competent doctor in the same position would have done. This lack of reasoning was found to be legally deficient.
The second point raised by the Federal Supreme Court, was that the lower courts failed to properly identify the legal culpability of each of the accused. In its view, the Court of Appeal was obligated to identify exactly how directly responsible each of the accused where in causing the death of the foetus, using this analysis to determine the financial liability to be paid by each of the accused. In particular, the Federal Supreme Court was not satisfied that the primary Courts had properly taken into consideration the question of whether this initial negligent act by the doctor was so significant of an operating cause for the death of the foetus, that it would in turn subsume the subsequent and related negligent acts by the other accused doctors. It was not enough for the Courts to prove that the accused where negligently liable; they had to prove how their negligence was a direct cause of the death, and whether certain accused individuals’ negligence liability was so gross and pervasive that it overshadowed the liability of the co-accused.
The Federal Supreme Court also criticized the lower courts reliance on the Supreme Medical Liability Committee report without independent judicial scrutiny, stating that while expert opinions are valuable, the Courts must ultimately conduct their own judicial investigations and independent analysis of the information.
In conclusion, the Federal Supreme Court’s ruling in this case highlights a more rigorous standard to be followed in determining liability in medical negligence cases involving multiple accused parties. The judgment balances the need to protect patients from medical negligence with the necessity of safeguarding medical professionals from unwarranted legal action. The Court emphasized the necessity of defining and determining whether gross medical negligence was committed and ensuring that each accused individual’s liability is independently assessed rather than relying solely on expert reports. It reinforced the principle that courts must establish a direct causal link between each defendant’s negligence and the harm caused, particularly when multiple parties are involved and when their involvement is a result of an individual accused’s actions.
For further information,please contact Ammar Haykal.
Published in March 2025
