Administrative Appeal Regarding Medical Liability Committee Decision

Federal Supreme Court

Session of Wednesday, August 7, 2024

Presided over by Judge / Dawood Ibrahim Abu Al-Shawarib "President of the Chamber" and the membership of Judges / Dr. Hassan Mohammed Hassan Hind and Khaled Mustafa Hassan.

Appeal No. 696 of 2024 Administrative

Legal Principles

1. Constitution "Freedoms, Rights, and Public Duties: Right to Complain". Medical Liability "Medical Liability Committees: Appealing Reports of Medical Liability Committees". Administrative Decision "Impermissibility of Immunizing an Administrative Decision from Judicial Oversight".

   1. Filing a complaint with competent authorities, including judicial authorities. A right for every person. Basis thereof.

   2. Error in medical liability. Its basis. Violation of the law by committing a medical error during the practice of the profession. Gross medical error. Its nature and concept. Determining the extent of the occurrence of a medical error. The jurisdiction of the Medical Liability Committee, and appeals against its decisions are before the Supreme Committee for Medical Liability. Basis thereof. Articles 6, 18, 21 of Decree-Law No. 4 of 2016, and Article 5 of the law's Executive Regulations.

   3. Immunizing any administrative act or decision from judicial oversight. Not permissible. Reason thereof.

   4. Final administrative decision. Its nature. A condition for accepting an administrative lawsuit. Finality of the decision.

   5. The issuance of a decision by the Supreme Committee for Medical Liability establishing a gross medical error committed by the appellant, having exhausted all its stages, is a final decision in its administrative capacity. Challenging it judicially through a lawsuit for annulment is permissible to review any defects in the administrative decision, provided its conditions are met. The appealed judgment's contradiction of this view and its ruling of inadmissibility of the lawsuit is an error that requires reversal and remand.

(Appeal No. 696 of 2024 Administrative, Session 7/8/2024)

Court's Reasoning

1- It is established, according to Article (41) of the Constitution, that every person has the right to file a complaint with the competent authorities, including judicial authorities, regarding the violation of rights and freedoms stipulated in this chapter.

2- It is established that an error in medical liability is based on a violation of the law, according to Article (6) of Federal Decree-Law No. 4 of 2016 concerning medical liability, which defined a medical error as what is committed by a practitioner of the profession due to any of the following reasons: 1- ........ Article (18) of the same law entrusted the Medical Liability Committee with preparing a report on the extent of the occurrence of a medical error, its severity, and in the case of multiple liabilities, the percentage of participation of each party in this error, along with a statement of its cause, the resulting damages, and the causal relationship.

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...causation between the error and the damage. Article (21) of the same law stipulates that a permanent technical medical committee called the Supreme Committee for Medical Liability shall be formed by a decision of the Council of Ministers... This committee is competent to consider grievances against the reports of the medical liability committees stipulated in this decree-law and shall prepare a reasoned report with its opinion on each grievance... The Supreme Committee has the authority to endorse the report, reject the grievance, amend or annul it, and its report is considered final and cannot be challenged in any way before any authority. Article (5/2) of the Executive Regulations of Decree-Law No. 4 of 2016, issued by Council of Ministers Resolution No. 40 of 2019, defined the concept of gross medical error and obliged the committee and the Supreme Committee, each within its jurisdiction, to consider complaints and grievances related to medical errors and to determine the following: a- The criterion used to consider the error committed by the doctor as a gross medical error. b- A statement of the elements available in the file that confirm the existence of a gross medical error. c- Specification of the type of damage and error."

3- It is established - in the jurisprudence of this Court - that no administrative act or decision may be immunized from judicial oversight, as the right to litigation is a public right guaranteed by the Constitution and therefore may not be confiscated. Although the right to litigation is guaranteed to all and has a final goal it seeks, represented by the judicial remedy that litigants strive to obtain to redress the damages they suffered from an assault on their rights, any infringement of this right or violation of the protection guaranteed by the Constitution, or denial of the facts of justice and equality in their essential features, is contingent upon the legislator's intervention by imposing objective or procedural restrictions that cause hardship to the litigants or make it difficult to obtain that judicial remedy or prevent it. Accordingly, the substance of oversight over the administration's actions is to verify the extent of its compliance with the conditions required by law in undertaking any action or issuing any decision.

4- It is established - in the jurisprudence of this Court - that a final administrative decision is one issued by an administrative authority and does not require ratification or approval from a higher authority, upon the termination of the stage that gives rise to the specified legal effect, by producing legal effects that affect the legal positions of the addressees of its provisions, having exhausted all stages of its issuance and become binding and enforceable, and fit to be executed immediately and directly, having exhausted all the administrative hierarchy necessary for its legal existence. An administrative decision cannot be challenged, and lawsuit procedures cannot be initiated against it if its approval or ratification by a higher presidential authority is required, or if its implementation requires the issuance of another decision or authorization from another body. Thus, finality in administrative decisions is a condition for the admissibility of an administrative lawsuit, such that the lawsuit is inadmissible if the administrative decision is not final, meaning it has completed all its legal characteristics and has become an enforceable decision.

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The Court

5- Whereas the decision of the Supreme Committee for Medical Liability dated 5/9/2023 was issued, which included the existence of a gross medical error committed by the appellant at a rate of 50% in the treatment of the patient... and this decision is final and has exhausted all its stages, the legislator considered it final in its administrative capacity. However, it did not immunize it from judicial challenge according to the established administrative and constitutional jurisprudence regarding the impermissibility of immunizing any act from judicial challenge to review any defects in the administrative decision (jurisdiction, form, procedures, reason, subject, and purpose), especially the extent of the attribution of the act to the appellant and the assessment of its gravity, which may require referring the appeal to an expert committee to provide its technical opinion so that the court has two medical reports in the appellant's case (according to the established jurisprudence of the Federal Supreme Court in Appeal No. 857 of 2023, session of 20/12/2023 and 27/12/2023) to ascertain his innocence or the proportion of fault, its gravity, and its degree, as it establishes a legal position for the appellant, thus becoming an administrative decision that can be challenged through a lawsuit for annulment when its other conditions are met. Since the challenged decision was issued on 5/9/2023 and the records are devoid of the appellant's knowledge of it on a specific date, and he filed his lawsuit on 6/11/2023, he would have filed it within the prescribed period for a lawsuit of annulment, which makes it formally admissible. However, the appealed judgment violated this view and ruled contrary to the aforementioned principles by finding the lawsuit inadmissible, which necessitates its reversal.

Facts of the Case

The facts - as evident from the appealed judgment and all other case documents - are that the appellant filed lawsuit No. 371 of 2023 Administrative Full Federal Abu Dhabi on 6/11/2023, requesting a judgment to annul the administrative decision issued by the Supreme Committee for Medical Liability on 5/9/2023, which included the finding of a gross medical error concerning him. This was based on the grounds that the members of the Supreme Committee for Medical Liability were not appointed by an unpublished administrative decision in the Official Gazette, the committee did not seek the assistance of a doctor in the same specialty as the plaintiff, and the element of cause was absent in the challenged decision according to the consultative medical reports submitted by him. Therefore, he filed the lawsuit with the aforementioned requests.

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Procedural History

At the session of 12/2/2024, the court ruled the lawsuit inadmissible. The appellant challenged this judgment with appeal No. 56 of 2024, and at the session of 22/5/2024, the Abu Dhabi Federal Court of Appeal ruled to dismiss the appeal and uphold the first-instance court's judgment. Thus, the present appeal was filed. The court reviewed the appeal in the consultation chamber and found it worthy of consideration, setting a session for its hearing, and the judgment was issued at today's session.

Whereas the appeal is based on four grounds, the appellant argues in the fourth ground against the appealed judgment for violation of the law, error in its application and interpretation, deficiency in reasoning, and flawed argumentation, stating that it was based on the premise that the decisions issued by the Supreme Committee for Medical Liability, according to Article (21) of Decree-Law No. 4 of 2016 on medical liability, are final and may not be challenged in any way, nor may an expert be appointed to follow up on it, which contradicts the legal principle that no act may be immunized from judicial challenge, a matter that warrants its reversal.

Whereas this argument is sound, it is established according to Article (41) of the Constitution that every person has the right to file a complaint with the competent authorities, including judicial authorities.

And whereas it is established that an error in medical liability is based on a violation of the law, according to Article (6) of Federal Decree-Law No. 4 of 2016 concerning medical liability, which defined a medical error as what is committed by a practitioner of the profession due to any of the following reasons: 1- ........ Article (18) of the same law entrusted the Medical Liability Committee with preparing a report on the extent of the occurrence of a medical error, its severity, and in the case of multiple liabilities, the percentage of participation of each party in this error, with a statement of its cause, the resulting damages, and the causal relationship between the error and the damage. Article (21) of the same law stipulates that a permanent technical medical committee called the Supreme Committee for Medical Liability shall be formed by a decision of the Council of Ministers... This committee is competent to consider grievances against the reports of the medical liability committees stipulated in this decree-law and shall prepare a reasoned report with its opinion on each grievance... The Supreme Committee has the authority to endorse the report, reject the grievance, amend or annul it, and its report is considered final and cannot be challenged in any way before any authority. Article (5/2) of the Executive Regulations of Decree-Law No. 4 of 2016, issued by Council of Ministers Resolution No. 40 of 2019, defined the concept of gross medical error and obliged the committee...

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...and the Supreme Committee, each within its jurisdiction, to consider complaints and grievances related to medical errors and to determine the following: a- The criterion used to consider the error committed by the doctor as a gross medical error. b- A statement of the elements available in the file that confirm the existence of a gross medical error. c- Specification of the type of damage and error."

And whereas it is established that no administrative act or decision may be immunized from judicial oversight, as the right to litigation is a public right guaranteed by the Constitution and therefore may not be confiscated. Although the right to litigation is guaranteed to all and has a final goal it seeks, represented by the judicial remedy that litigants strive to obtain to redress the damages they suffered from an assault on their rights, any infringement of this right or violation of the protection guaranteed by the Constitution, or denial of the facts of justice and equality in their essential features, is contingent upon the legislator's intervention by imposing objective or procedural restrictions that cause hardship to the litigants or make it difficult to obtain that judicial remedy or prevent it. Accordingly, the substance of oversight over the administration's actions is to verify the extent of its compliance with the conditions required by law in undertaking any action or issuing any decision.

And whereas it is established in the jurisprudence of this court that a final administrative decision is one issued by an administrative authority and does not require ratification or approval from a higher authority, upon the termination of the stage that gives rise to the specified legal effect, by producing legal effects that affect the legal positions of the addressees of its provisions, having exhausted all stages of its issuance and become binding and enforceable, and fit to be executed immediately and directly, having exhausted all the administrative hierarchy necessary for its legal existence. An administrative decision cannot be challenged, and lawsuit procedures cannot be initiated against it if its approval or ratification by a higher presidential authority is required, or if its implementation requires the issuance of another decision or authorization from another body. Thus, finality in administrative decisions is a condition for the admissibility of an administrative lawsuit, such that the lawsuit is inadmissible if the administrative decision is not final, meaning it has completed all its legal characteristics and has become an enforceable decision.

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Ruling

Whereas this is the case, and the decision of the Supreme Committee for Medical Liability was issued on 5/9/2023, including the finding of a gross medical error committed by the appellant at a rate of 50% in the patient's treatment... and this decision is final, having exhausted all its stages, the legislator considered it administratively final. However, it did not immunize it from judicial challenge, in accordance with the established administrative and constitutional jurisprudence on the impermissibility of immunizing any act from judicial challenge to review any defects in the administrative decision (jurisdiction, form, procedures, cause, subject, and purpose), especially the extent of the act's attribution to the appellant and the assessment of its gravity, which may require referring the appeal to an expert committee to provide its technical opinion so that the court has two medical reports in the appellant's case (as established in the jurisprudence of the Federal Supreme Court in Appeal No. 857 of 2023, sessions of 20/12/2023 and 27/12/2023) to ascertain his innocence or the proportion of fault, its gravity, and degree, as it establishes a legal position for the appellant, making it an administrative decision subject to a lawsuit for annulment when its other conditions are met. Since the challenged decision was issued on 5/9/2023 and the records are devoid of the appellant's knowledge of it on a specific date, and he filed his lawsuit on 6/11/2023, he filed it within the prescribed period for a lawsuit of annulment, which requires its formal acceptance. However, the appealed judgment contradicted this view and ruled contrary to the aforementioned principles by dismissing the lawsuit, which necessitates its reversal, with the case being remanded.