Given that M. X tried to commit suicide on 2 October 1987 by taking an overdose of the pills prescribed for his heart condition and depression, was taken to a clinic of the Mutuelle générale de l’Éducation nationale to have his stomach pumped out and his heart monitored, and was installed in a second-floor room next the clinic’s intensive care unit; that the next day, when his wife, a doctor and a nurse were all in the room with him, he suddenly opened the window, which had no locking device, and threw himself out, receiving serious injuries; that when M. X sued the clinic the courts below (Versailles, 8 February 1996) dismissed his claim on the ground that the clinic had not been guilty of any fault;

Given that M. X criticises the decision of the court of appeal on the ground that all hospitals, not just mental hospitals, should take particular precautions, even in the absence of specific orders from a doctor, to prevent any risk of the recurrence of attempted suicide by a patient known to have suffered from depression whom it has admitted for an emergency stomach evacuation prior to sending him to a neurological unit, and also because the court should have inquired whether the decision to transfer the patient to a psychiatric unit as soon as possible did not require it to take all measures to prevent “an irremediable act”;

But given that the court of appeal was entitled to infer that in all the circumstances the clinic was not guilty of any fault as regards its contract to accommodate and treat the patient, those circumstances, according to its own reasoning or that adopted from the trial court, being that in view of his history of heart trouble M. X had been placed in the cardiac unit of the hospital on the orders of doctors, including his psychiatrist who recommended this treatment pending a decision the following day about transferring him to a unit for depressives, that the staff of the clinic had not been shown to have had any knowledge of M. X’s previous treatment for depression or of the risk of a renewed suicide attempt, with consequent need for constant supervision, and that the room in which M. X was placed was in the only part of the clinic where the services required by his condition could be supplied, with both a doctor and a nurse in attendance at the crucial moment;

For these reasons, DISMISSES the application for review.

Civ 1, 3 March 1998: This solution is an old one. Cf Civ 1, 4 May 1970 (Bull no 153) establishing that a clinic had no liability when a patient had terminated his life where the clinic's staff had not known of the patient's suicidal intentions. Conversely, any negligence on the part of the clinic's staff - if they were warned of the patient's state - would be likely to involve contractual liability on the clinic's part (Civ 1, 2 March 1964). This obligation of security is not limited to psychiatric institutions alone (Civ 1, 23 February 1982, Bull no 84: cure institution). The judgment of the 18 July 2000 (cf supra) mentions this obligation of surveillance which falls upon a psychiatric clinic which has left a patient alone when his suicidal urges were obvious, an obligation which flows from the contract for hospital services and treatment between the clinic and its patient.

Translation by Raymond Youngs

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