$63(&726%È6,&26'(/$'2&75,1$'(/'$f2 '(6352325&,21$'2(1/$5(63216$%,/,'$'&,9,/ 6$1,7$5,$ BASICS ASPECTS OF DISPROPORTIONATE DAMAGE IN THE CIVIL MEDICAL LIABILITY (!.!%!,!Q."=.!+Q 5HFLELGRG*0- $FHSWDGRG- 5HVXPHQ<**1;0<* %-#*00>$-6701 **/66>"B7* A < ) -6 4 * */77**8>"*-98 *01<***-0'64*0 0 < * ' 2 */>%-B7 **9*6*A0> 3DODEUDVFODYH<**6*-0'67767 *-6*68> $EVWUDFWthe doctrine about the disproportionate damage was used in the last years by the Supreme Court in many occasions. In spite of that, the arguments used for its application, are not evident and even contradictories. This form is based on the existence of a damage with considerable features, which detach one presumption of negligence prescribed by the doctor . This project show of a detailed analysis about the disproportionate damage in the civil responsibility of the medical institution, which will allow the reader determine when a damage can be used in this doctrine and which are the consequences due to those application. This research, deal with this figure from a jurisprudence perspective, starting form the current doctrine in the field. .H\ZRUGV disproportionate damage, civil liability of the health services, negligence, burden of proof, patient, medical. 680$5,2 > $%!,++N$P > !"# ,$#53 (a+ R ], "# !, ,!+,$,P > +,$+" %, " ], "# !, ,!+,$,P >> +*9*P>>+*P>> 7BP>>>3 *4P>>>3*P>>>3*-Tprima facieUT-YUP >>> 3 * Tfaute virtuelleUP H> !"m#%,#P H>> 3 * <4*077PH>>"<* * 4 8 8 *- 2 8P JJF e-##$1697-5723 Margarita Rodríguez García H>>A*A)0PI>" "+%,#PL>3+!."3 !"5PE>+,$+3#,$"#P553,.! Q> ,1752'8&&,Ï1 " * -9 * -9 ) < ** 0- *- 0'> " 9****- 4 A < 4 * 7 A*->"B770**060A <7-60*4606*/ *077>;**onus probandi6 4 *- probatio diabólica> " 7 0 0' 2 6 ) 0 0-064*62*0 4)0**67/< *80'*26*62- 6006 07'2*> "0*/*-0'*776 *-**#%#F02JJ6!&JJLF>)6#%# E02E!&EIIA*4GT**- %# LJE f!& JJE6 FLJg * *- <6)2/28/-*8 lex artis ad hoc>06-7/0'%#JIFE 2JJFf!&JJF6JHEg--66 -7/0907*8 07)'2/6*4* <606*-0'U >&>> $-624*40 -9/ *->)6 0B / 4 0* * 77 4 / 86*4-7/0>%20 A* ! 31 T 2 9*6 0 7 76 *-*80*- -96 4 *- 0 0 -962646*6**/*6/ 7*-60*<76* **-*2/U>"6 9**0*774 860*/0< **6-9> JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... 3 *- - 0 4 A *77/*6)0*/ <2/> 0677 *8**-4/0* 7 A7- 8 0 0 2 >)6 0 0 lex artis *86 4 * 8000/8 264809-0'642 0lex artis ad hoc24666- 80/60**86- 2B/> - B *- * * * <**649)'707 *-**> 1 -96 1/ *- 0' 2 < **> 06 * 2 4 4 - **/>/'840**/ '> 06A0'7*-* 41*/<**> 5(63216$%,/,'$'0e',&$<'$f2'(6352325&,21$'2 +06*-*8/0'- *6A2*/8-4*70 6'***/40*06 7;0A0A*60*77 00*2D20*1/>" 670)<**64 4**/G*076*< 4*)8*1/77>"7 7647*74*8 /8/> ;064<2 */0/A)0> "%-#*0*)<** 00*/*-*/ 6 80 4 < ** )04A 770'6*40<*04* 72*0*/ 2*/> "69B/*// 80%-#*064MA-1 7742<-7)H++0* JJF e-##$1697-5723 Margarita Rodríguez García )E3"+T8*- -*4)08-*/* 0 8- * *- *A0 8 *-U> " 82*-*-4* <02**/0'2< /8*-*-6* 77640-6*-04 *-/)0*0-*6 20'> +0 6 * 4 7 0 *-A7*-*2/ * * *6 * 7 A*6 4 < ** 0 /0'2<> &21&(372'('$f2'(6352325&,21$'2 &RQFHSWRHQODMXULVSUXGHQFLD 39*8*4 <**P-6**)0 0/7B>"%-#*0* <**T40'* 0 0 7 2 ** / 7 4 0* / / *0 4 >&>U#%##+0 0-6!&IFL>"6#%##+ 02!&EE2F0-E!&EFI66 014707<4T4'* A*-8/*8U> 3# %7#/>j0-+J */B/1*%-#*0< 4T4A2/<000*)0 *-2*-U >&>E>006# .*;1#/j- J+JL<0'B/A*4T <-0/40*- 7700*4< *U >&>> 6 9* A* 4 < ** 4 4 9 4 < 4 *- 2 4 0* /667)*> 64 0!0$(64-4' 7)*/2*6- JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... <**>06)0B/ B7> #- *6 * #%# I $0- 3 32 FED A* 4 T 0 - ** 4 0*0 6 A */ 8- - A7-U >&>L>) <**/0*80< 4 0 2 ;0 * "*<6 4 A T ;0 * 4 8 1 0 6 * 0 2 * 70 0' 2 - 6 < *6 6 * 0* 7 U >&>L> # 0-76*0*41/06* 72B28*/0*- 424T07U2**< **> 000*#%##+0 0- !& IFL A* 4 */T0*2A* 0*0640/ 2 4 8 / '6 -) 7 4 A) 776 26 * 6 * *-'U >&>H>)6<** 0*80'-7 4 *9 < * ** 8 2 *A0 *- #%##+9F6!&FHHL>$-60 068*-40/77664/ 80lex artis-6*0*- <**> 0969*-)0* <**6*4B26 7 8 B76 0 * 6 *--9%A!832.* 8+02220*00 *'# (#/>jF96+FIFE6/4 0* 4 2 9 86 * 4 8 -/ 7-2*19'*9<6)4 **<62460-6-7/8 02> &RQFHSWRHQODGRFWULQD 3 B < ** 0 T4 * 0' 4 * 06 / 0 JJF e-##$1697-5723 Margarita Rodríguez García H 7/740*2*04 60*-*0U>"< **/0600' 6 4 * 0* *- 2 B /> 4 0* /B6 7 ;0 )0 * 4 4 * /0 / 0*0> $ -6 B/ * 0- 0/T0U6*49* 0 * 06 0*0 */ *14*>30 0-6*4 T00764*- 8 * 2 / U > #- ' 00 * *)1 1A*4<** T0-4'**/<U60* <0*0027/B60* 4-> 6 < **6 * B 0 4 8 4 - 7 )* /6-87A7-2* '**66lex artis> 3-*810/*6 424B4*0020 B/400/<**> 068)-&2%-790> )LJXUDVD¿QHV 3<****%-#*0 90 B7 B6 46 * 6 * *- 4 * 7 res ipsa loquitur - * ) 006 4 B 4 / 7762*80*702 7 T)-Y)U 06 ) 0 8 T8U2*;0*9>";044 *1<400**1/ 77647*74 8/041A 2400*/4* 8**)0> #-**30 0-A*4* */T*00104 917-*20 246407'7)I++U> JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... I #7; B0/6 *0 4 B9 0 *- 2 0677*-**> 39*%-#*04*7res ipsa loquitur6*-*6Anscheínsbeweís**-2 faute virtuelle<**> " 0 */6 %- #*06 8 ' 7 <**6*08006* 40*72)74 *079/60628'> 3.3.1. La Res ipsa loquitur 3 < ** 0 7 0A0res ipsa loquitur>"67+003Y61 0-01/*<2*9 * *- 77 86 */ < 0*- 02 8) * 4 < * -*--A77->" %-#*0#+#J9JJJ!& JJJHFJI6J0-JJJ!&JJJFE6!& J2I*0-!&LHF64B70 40/4804 /77>"<4*01*4 *877> "7)0*/9816*4/ 0*)4<*864 *940*A<2/6 / )0 * 8 8102>37res ipsa loquitur7A*0#%## +J0-JJF!&JJFJHE>"* 49240*/8 4 ) *'6 * ' 7 *4;7> " B04GT-<**6 4 * *- d6 4 * 7 * 4 - * ) 006 4 B 4 / 77 2 0*0 * 7027-Y**- 02600688 * P 4 4 4 *1 < 4 00 * * 1/ 776 4 7*748/ 041A2400 */4*8** )0U >&>> JJF e-##$1697-5723 Margarita Rodríguez García L 6 *) 4 < ** * 08/*Bres ipsa loquitur6*6/79 A7004*0-)> 3.3.2. La presunciones 3*960-'0presumptio hominiso facti6 7 ) FL 3"+> * - 80*-4**06 *4B*6 4*> +0*30 0-6*0*0'6-6 *0*> 6*4 *0*04*0*0'67B 4**0*>"'0 M9#%##+8-JJ!&JJLEE># -41-/*80 A4-080/7'*)6 4 'A 2 */ 0 * 86 4 **>"#4A*4 *A0824*/)1/ 4;7T**/4-*7; U6 * 4 * - 6 7 0 4 </ 644-6/7 6A60)0*-/7*6 *- * 4 8> $ -6 0* < 4 2#0#%##+E8-JJ!& JJLLF4*4<** * 6 * * )> " 6 A*4T8*-61/* A7 / 8 < 2 0 6 048*-624 *000'6204;76 4 * -- 0* 0*-6 2 0* *- 02 0 7 7; /U >&>> 6*94*6* 4*0*864*-807 -*/> 3.3.3. La prueba prima facie o Anscheinsbeweis #)2*T0A0A*U7; )20*res ipsa loquitur>:24 JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... E **/96*-> " */ 2 *- 4 A7 0A0 A*6 -96 ) 2 B-6 4 -7 7 / *> " 6 *- prima facie * 0 )*6 4 0*- 6 4 7; A*6A0 *>31/)4A)*64 0*-6 7; A*6 A 0 *> 6 B9 * *- 0**-->34*4A*24 67040-/> "%# # + B0 # 0- H !& IHH 4 T- d 4 2 *6 4I++68/76 -A*46*-9*'6- 2 4 1- 024&1*1-**77;4 */**U >&>> 3.3.4. La culpa virtual o “faute virtuelle” "80007 */9*/<**> 34*770>") 0* 0 res ipsa loquitur6 4 80 4 0 0*- *'06***0>"67 **AA /2/066<> # * #%# # + 0- JJF !& JJFJH6 4 - * 6 1/ **6A*44/06 49**-)00*61/ **/-77 >&>H> "6*#%##+H8- E!&EILI64-802$#3> "%-B04T/*8 4*-00-964* /7*-d66*67* 7*-*77*64 9*0*40'4;79 81*8/9/'0')BA7- *00lex artis ad hocd>R40 JJF e-##$1697-5723 Margarita Rodríguez García F 877;*80'4* 776'*-*-*41' 4;706*0*<67 /74*80*064 79/6106040*060 9TpraxisU07A706- 60U >&>> 3 B ) *0 * 2 A ' 00A0A*>#*0 *0'204**8 -*-*>")0-'**- 4 0 * A *-6 *- 4 <-8//64A8 0*6 4 / * 41 6 8 A88102> 5(48,6,726 3 4 4 - * */ ) < **0%-#*0## +J0-JJF!&JJFDJHEA*4T4 44*1<400* *1/77647*7 48/041 A2400*/4 *8**)0U >&>> 64 A74A*/> /DSUHVHQFLDGHXQHYHQWRGDxRVRGHORVTXHVHSURGXFHFXDQGRPHGLD QHJOLJHQFLD */)*<6 *-8BT<U6- 10*473124B0T 0-4008 *2-62***0U> "<406/4*29*6 0*/006*44*0 **> "604B0-*6 T0U7;!"T8U604T**/UT8 **/-U>+0*060-*4*- )6*4*8)0/P-6* JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... J *A0/ 0 0 * 1 B 4 009*> #- *6 0-' * 3 R76 1 /<02767B/B20> "/0276*1-444 0*/0277*0*2 060A0A*)*0* 00048*-> 3 **/ * 0'6 - * / 4 9> " 6 3*/A*4T<**/0 00'64* 0**-2B/U>0006)1 1 A* 0/ **/ <6 4'44*7;0)064 4*T/0/0*0U> " %- #*0 0 B < **0T0U6-600*4' < - 7 6 4 T- 4 -002'lex artis debidaU> 6 * B 0 < ** < 8*1-7)*/6 0*40*-6*7 A7-2*'**> 0*6B<**000* 24094A*404'4086* 90*6<***)B0406/ 0*/4)*-4*9> 4*1/<00*/6 0/A/0<> 3 < ** - B 7 )*64/**401 74*9/>$-67)* < **6 4 4 ) 6 - /6 06 2 - / *0*2*-/> #- 7 )* 0* * *G *0 644*080 874*/60'> 6 * 4 7 9 *0 4 - lex artis ad hoc6 * 01 7 )*> " /8-7;**776 *6)*/)7**>( JJF e-##$1697-5723 Margarita Rodríguez García 4744017)*2* 80804> 90* 4 8 -9 ) < **6 4 *9 8 7 )* /6 A0 * #%# # + !&LHL64*41(7 ()+64*/')2*7 4T'4;7**082 70086/</ 8)6 / 0 8) A ' 4;7 * 2 6 B6 B -*6M28 */76 0*/ < 9 0 0 resultado desproporcionado4*-7)**- *-/P06B7)* **U> "# (#/>jEE+EJEI 0/*/)<**6*4 4*9887)*/ 4;7>3/9*280 ***-9>"7<8 T/4;7U6*9B*-8 *4 8 < ** T 7 00 6 * B T **U < 8*-7)*/6 60*4*--9 7A7-2*'**>#/ 4*61/04 674;764*9-/' 40807)P*4 0*/U >&>H> (O GDxR VH SURGXFH SRU XQD FRQGXFWD TXH HVWi IXHUD GH OD HVIHUD GH GLVSRQLELOLGDG\FRQWUROGHOIDFXOWDWLYR 1**04662*0 *86'--9*64 4*701/> *0 46 4 8 2 /642642 *- 9 > " 4 A 840*<64*A*- T8 * * 1 04<U> JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... 6 * * ) < ** 4*472*-6 * 4 < 0*- 7; 4 8 8 / *8 #%# # + 0- J6 !& F> 006 ##%# # + 02 F !& FE 2H0-&!DH-4T< 7*48*- 06 4 *0 2 7 * 4 * */*68042'8** res ipsa loquitur6*A<2U >&>> 6<7*48 *-862*/*) <**> #8*-480Tlex artisU*) 0*-<**6 *4-)A77-)*/00 <**>$-6)41 lex artis ad hoc6*40)2 4*2*7;>"6 #%# # + H 0- I !& IEFII A* 4 *8*7;<6***4 *16*-48-77#%##+ 016!&6JFH6*-)46 *464780*/#%##+ 9JFE6!&JFEIHFF> ,QH[LVWHQFLDGHFXOSDH[FOXVLYDGHODYtFWLPD ";04*4A/4* 8 / < 4 * *>4) )0-TUA2*/ 778>"60/0- 0*0*4-*/<> "-T4*0-*/A 6culpa exclusiva de la víctima> 6*M */ < 2 * / 0/6 A7 *- 78*67;A*157 -/76*4T0*0*96 0-680*-* <>6846*0 <U>46*400A*4T /)06*1 00)-*77>"6-- JJF e-##$1697-5723 Margarita Rodríguez García A * )0> # 0-76 d 9* 0-' 0* *- 4 2 A 0*0 *<6/*'740 0U> 0 96 * * ) / 7*)00*/<**6 *4'97)*6)8**)0 *080> $ -6 -) */ * /7 9 *6*4<*** 0->3*/*T208 ***0*)01U>"- 4*/77T*2/ <20U66 **0*0<> -6*00644/6 *6*44*/)6 006*2*-/ <> ()(&726 3 8 */ ) G * 6 */ A*77**8> 6 -7/**00*-4-/lex artis-* /64<88/> ;064A*A)0> 3 */ 0* 4 0 **6 *0 4 A * 86 44-70 7;07766/807lex artis ad hoc>%0*4*-00*04 88/> -6 *6 7; 7 < ** * *0 -9/6 * 4 * 6 07706012 8*G**A A/2/04) <*>0603*/A*4 T**00*-prima facied64* A4-*/- 062*6*U>006!31 <4T-/2*/lex artis ad hoc607-*-/ JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... 6*6*0080 62*677/*6 *-A7-6*2**620 2 ex artis6 0 **/ <U> 60*/4* <**4*0480* lex artisA7-> *624*4*-9/ *-*-*76*4*- 88*68/7 24/<>"%-#*06# # + - F !& FIEFJ6 A* 4 <**0*-9/*- 8T6*-6- res ipsa loquiturU >&>L>064< **807*-**6 *46*0*0'60*> ;06<40*4*) 9-97*/7*-64 * * 006 * 4 4 * ' 07*->06*4)- 7*-6*4** ) 77> )6 7 *- 4) *1 864-*-/7-606 9B/-620/*0 0*/*-> /$&$5*$'(/$358(%$ 4*9**- 0/4'*66 4'*0T7*-U>"43R70 T-/ 0 7 *-U6 * 46 ) 7*-06609 **-40> 3)<**-**- *-**64-001 8 *-6 0-' 0' *)* 7 *- 6 * * 2 < **6 *) 4* */ ) E>L 3"+6 B 8/ *9> " -B-*-***926 ** 4 ' * JJF e-##$1697-5723 H Margarita Rodríguez García 8>#-*A*3*/4 <**27*-*6 069T00*-0* 8onus probandi64*- -/**7*-<6/ 28/lex artis ad hoc6*7)0 < 2 *8 / 1 / 0'6*-2/)B '00U> " %- #*0 4 / 0- *-0'#+0- JJL!&JJLFJF680T-**-6 0-'62002806-8064 * ** 0 ' 0 7 2 * 0 **/71*/*009 4**)0690'26*6002 B-*-6*/00 ** 0' * 46 4' -6 4' 0 0 8 * *8/U >&>> " 86 # < */6 46 * 4 -7/80260 **'*/8*> "00#%##02JJF!& JJFJJ *1 7 *- 4 / 8 280lex artis7'0GT* 0' 2 0*6 8/ ) 8 *- 2 09 */ * 006 7 *- 480*-2-62*/* 4704/67;*47 0A0A*U >&>> 3*/0)04*0-7 )HJ++640)*94 */0-'0 > 6 *) 4 ) < ** *6*)/7*-6244 04*-<0**6) 0/>"007*-) 064)4T-U6) 000*--4*-0 > +0 B0 # %- *0 # +IE!&EDIIA*4TA7 *-0*0*8-8 JJF e-##$1697-5723 Aspectos básicos de la doctrina del daño desproporcionado... 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