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Porušenie prevenčnej povinnosti


 | 12.6.2014 | komentárov: 311

V sekcii judikatúra neprehliadnite rozhodnutie Najvyššieho súdu ČR, ktoré pojednáva o zodpovednosti zdravotníckeho zariadenia za porušenie prevenčnej povinnosti (sp. zn. 25 Cdo 695/2012).

Pri operácii bedrového kĺbu, ktorú žalobkyňa J.S. bola nútená podstúpiť, došlo k poškodeniu stehenného nervu, čo jej spôsobilo problémy pri pohybe. Žalobkyňa sa preto rozhodla žalovať zdravotnícke zariadenie, v ktorom zákrok prebehol a požadovala náhradu škody. V priebehu konania pred prvostupňovým súdom bolo znaleckým dokazovaním preukázané, že operačný zákrok prebehol lege artis a poškodenie stehenného nervu bolo spôsobené inými príčinami, ktoré „ mají původ v samotné léčebné péči poskytované žalovaným, lékařská věda nestanoví přesné postupy a u nejpravděpodobnější příčiny záleží spíše na zkušenostech a zručnosti operatéra.“  Lekár vykonávajúci operačný zákrok má povinnosť „s přihlédnutím ke zdravotnímu stavu pacienta zvolit metody a postupy operace, které pacienta nepoškodí, nebo zvolit postupy, které sice představují riziko, avšak na ně byl pacient předem upozorněn.“  Keďže žalovaná strana oboznámila žalobkyňu o možnosti poškodenia stehenného nervu len veľmi všeobecne, došlo k porušeniu jej prevenčnej povinnosti, a teda zodpovedá za škodu, ktorá žalobkyni vznikla.


Žalovaná strana sa rozhodla podať voči tomuto rozhodnutiu odvolanie. Druhostupňový súd sa však stotožnil s právnym názorom prvostupňového súdu, keď uviedol „že pro odpovědnost žalované je postačující zjištění, že všechny pravděpodobné příčiny poškození zdraví žalobkyně se týkaly buď samotné léčebné péče nebo se jednalo o zvláštní objektivní odpovědnost za škodu.“ Prevenčná povinnosť podľa odvolacieho súdu nie je porušená v prípade, ak lekár koná „s takovou opatrností, která obvykle stačí k zabránění předvídatelným škodám.“

Žalované zdravotnícke zariadenie podalo proti druhostupňovému rozhodnutiu dovolanie, v ktorom namietalo nedostatok zavinenia ako jedného z predpokladov zodpovednosti za škodu, pričom iba samotný predpoklad jeho existencie nepostačuje.

Najvyšší súd ČR v odôvodnení rozhodnutia uviedol, že zodpovednosť za škodu môže vzniknúť aj v prípade porušenia prevenčnej povinnosti, keďže pri všeobecnej zodpovednosti za škodu na nejedná o zodpovednosť za výsledok.  To, že pri operácii bol poškodený stehenný nerv, neznamená zanedbanie povinností zdravotníckych pracovníkov, vrátane prevenčnej povinnosti. „Závěr, že lékaři při operačním výkonu porušili právní povinnost, nelze totiž činit bez zjištění, že porušení nervu bylo způsobeno jejich jednáním či opomenutím. To platí i v případě porušení prevenční povinnosti. Příčinou vzniku škody na zdraví, za niž odpovídá žalovaná, není totiž samotný fakt poranění nervu, nýbrž jednání či opomenutí na straně žalované, které k poranění nervu vedlo; za situace, že postup lékařů při operaci byl shledán lege artis, může být dána odpovědnost zdravotnického zařízení, byla-li škoda na zdraví způsobena takovým jednáním či opomenutím zdravotnického personálu, jemuž bylo možno předejít a které lze kvalifikovat jako porušení prevenční povinnosti.“

Prvostupňový aj druhostupňový súd sa vo svojich rozhodnutiach priklonili k názoru, že postup zdravotníckeho zariadenia síce bol v súlade s lege artis, avšak uznali jeho zodpovednosť za porušenie prevenčnej povinnosti, pričom konkrétne neuviedli, v čom toto porušenie malo spočívať. Najvyšší súd sa preto rozhodol predchádzajúce rozhodnutia zrušiť a vrátiť vec prvostupňovému súdu na rozhodnutie.

Spracovala: Ľudmila MOĽOVÁ





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