justice cannot decide more than ten years later

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A legal journey certainly tiring. A new expert was mandated by the Paris administrative court to look into the “very serious” complication experienced in Paris by a young patient from the Saint-Louis and Bichat hospitals (APHP) after her heart surgery in 2011.

A “very urgent” heart transplant

This woman – then aged 25 and suffering from Barlow's disease, a heart disease – initially presented herself on July 21, 2011 to the emergency room of the Europe medical-surgical center (CMC), in Port-Marly (Yvelines). ), due to persistent fever, neck pain and nausea. She was then diagnosed with nasopharyngitis and placed on antibiotics.

The next day, July 22, 2011, the applicant presented herself this time to the emergency room of the Saint-Louis hospital, in the 10th arrondissement of Paris: the doctors instead detected “probable meningitis” and admitted her in the infectious diseases department. A “probable viral infection” was then diagnosed given the deterioration of his state of health. She finally underwent heart valve surgery on August 11, 2011 at Bichat hospital, in the 18th arrondissement of Paris, and had a “bioprosthesis” fitted.

But three hours later, the patient suffered “global heart failure”, which required the installation of “ECMO circulatory support” – an external machine which replaces the vital functions of the heart – for sixty years. ten days. A “very urgent” heart transplant had also had to be carried out, but its consequences had been complicated by “early dysfunction” of the graft and “renal failure”. The patient therefore had to undergo a kidney transplant, this time at Saint-Louis hospital.

However, the young woman was not at the end of her ordeal: a “new transplant” of the heart had been carried out on December 3, 2012 at the Bichat hospital and “several complications” of a “urological” nature this time – in link with his kidney transplant – had come to light… “Transfusion-related hepatitis E” had notably been diagnosed to him by the doctors. His cardiac situation was only finally deemed “satisfactory” in January 2019, eight years after his initial admission to the private clinic in Port-Marly.

She was in danger of dying

Under these conditions, the patient had requested to be compensated for her damages by the National Office for Compensation for Medical Accidents (ONIAM): she estimated them at more than 1.6 million euros. But ONIAM considered that the conditions for compensation through “national solidarity” were not met, due to “the seriousness of her previous condition” and the “very complex care” from which she had benefited. The young woman therefore appealed to the Paris administrative court in September 2022 to reverse the situation.

“ONIAM must ensure, as part of national solidarity, compensation for damage resulting (…) from acts (…) of care on the double condition that they present an abnormal character (…) and that their seriousness exceeds the threshold defined (…) in the public health code”, therefore begins by generally recalling the Paris administrative court in a judgment dated October 4, 2024 which has just been made public.

“The condition of abnormality (…) must be considered as fulfilled when the medical act led to consequences in particular more serious than those to which the patient was exposed with sufficient probability in the absence of treatment,” specifies the court.

In this case “the serious infection from which Mrs. “Given the lethal risk of infection (…), the intervention did not lead to consequences particularly more serious than those to which Ms. XXX was exposed. » But the magistrates lack information to assess the “abnormality criterion” of the applicant’s “damage”.

“The “extremely serious complication (…)” from which Mrs. The same experts even noted that such “dysfunctions (…) as serious” are “extremely rare” after heart valve replacement.

But their report “does not make it possible to precisely determine the probability rate of occurrence” of a complication “of the same type and of a comparable level”. This will therefore be the task of the new expert who was commissioned by the Paris administrative court.

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