Medical Negligence and Vicarious Liability in the UAE: A Case Study of Dubai Court of Cassation Judgment No. 377 of 2025

9 min 6 sec May 20, 2026 (Edited)

Written by

Mohamed Al Marzouqi

Partner,
Head of Office – Abu Dhabi,
Co Head of Dispute Resolution

m.almarzouqi@tamimi.com View LinkedIn Profile

Dr. Omar Al Azawe

Of Counsel

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Zane Anani

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On 28 August 2025, the Dubai Court of Cassation issued Judgment No. 377 of 2025, a landmark ruling addressing several critical issues in medical liability law in the United Arab Emirates. The court considered the following important legal questions within the framework of Federal Decree-Law No. 4 of 2016 on Medical Liability:

• the evidentiary authority of Medical Liability Committee reports;
• the scope of vicarious liability of medical centres for the errors of their physicians; and
• the assessment of compensation for physical and moral damages.

This article examines the principle grounds of appeal raised by the appellants, the key legal principles affirmed by the Court, and the judgment’s broader significance.

Case background

The facts

The respondent (the patient) attended a medical centre (the second appellant) on 25 November 2023 seeking treatment for obesity. The first appellant, a physician practising at that medical centre, examined the patient and determined that she required a mini gastric bypass procedure. The surgery was performed not at the medical centre itself, but at a separate hospital (the second respondent), pursuant to an agreement between that hospital and the medical centre.

Following the surgery, the patient suffered severe haemorrhaging. When she contacted the operating physician, the patient was merely reassured, notwithstanding the gravity of her condition. Her deteriorating state led to her admission to another hospital (the fourth respondent), where an endoscopy and partial gastrectomy were performed. She was subsequently transferred to a hospital in Abu Dhabi (the fifth respondent), where a further series of medical interventions were undertaken, though her condition continued to decline.

The patient filed a complaint with the Medical Liability Committee, which concluded in its report that the first appellant had committed gross medical negligence by performing surgery in a manner that contravened established medical standards. The Committee found that the negligence resulted in a complete loss of stomach function, constituting a permanent disability assessed at approximately 100% of the natural function and capacity of the stomach.

Court proceedings

The patient instituted a civil case seeking an order that the appellants and the hospital where the operation was performed pay, jointly and severally, AED 1,100,000 in compensation for material and moral damages, together with legal interest at the rate of 12% per annum from the date of the claim until full payment, as well as AED 407,426.16 in treatment expenses.

The appellants joined the insurance company (the third respondent) as a third party, seeking an indemnity on the basis of a medical malpractice insurance policy, and also joined the fourth and fifth respondents for the purpose of obtaining documentary evidence.

On 28 April 2025, the Court of First Instance:

1. dismissed the joinder of the insurance company on the ground that it had not been brought through the proper procedural channel prescribed by law;
2. accepted the joinder of the fourth and fifth respondents in form, but dismissed it on the merits; and
3. ordered the two appellants to pay the patient, jointly and severally, AED 700,000 as compensation for both material and moral damages, together with legal interest at the rate of 5% per annum from the date the judgment became final.

Both the patient and the appellants lodged appeals. The appellants then filed the present cassation appeal (No. 377 of 2025) on 21 July 2025.

Grounds of cassation appeal

The appellants raised six grounds of appeal, the most significant of which may be summarised as follows.

Challenge to the Medical Liability Committee report

The appellants contended that two members of the Committee had a prior adversarial relationship with the first appellant and had failed to disclose this when accepting the complaint for review.

They further argued that the report was devoid of any objective medical examination of the patient’s files held by the relevant healthcare facilities, including the hospitals in Abu Dhabi where subsequent gastric procedures were performed.

Severance of the causal link

The appellants argued that there was a break in causation between the complications and the original surgery, asserting that the patient’s condition had stabilised for a period exceeding 40 days after the bypass procedure, thereby indicating that the subsequent complications were attributable to the later medical interventions carried out at other hospitals.

Denial of vicarious liability of the medical centre

The second appellant argued that, as a medical centre, the operation had not been performed at its premises nor under its supervision, and that it should therefore bear no responsibility.

Proportionality of compensation with Diya and Arsh

The appellants contended that the compensation of AED 700,000 should not exceed the Sharia-prescribed Diya (blood money) or the proportionate Arsh (compensation for bodily injury), relying on principles established in Federal Supreme Court jurisprudence.

Key findings

Authority and finality of Medical Liability Committee reports

The Court undertook a comprehensive review of the legal framework governing medical liability committees. Relying on Article 18 of Federal Decree-Law No. 4 of 2016, the Court confirmed that the Medical Liability Committee is the body exclusively competent to examine complaints and determine whether medical negligence has occurred and, if so, its degree of gravity.

Article 20 of the same law provides that the Committee’s report becomes final if no grievance is filed within the prescribed 30-day period, after which the report may not be challenged before any authority.

Article 21 establishes the Higher Medical Liability Committee as the appellate body for grievances against the primary Committee’s reports, and its reports are likewise deemed final and not subject to challenge before any authority.

The Court also established that the filing of a complaint with the Medical Liability Committee and the issuance of its final report constitute a mandatory precondition for the admissibility of any compensation claim based on medical liability before the courts.

As to the appellants’ allegation of bias on the part of Committee members, the Court dismissed this as an unsubstantiated assertion devoid of supporting evidence.

It is worth noting, however, that certain judicial precedents have permitted, by way of exception, the filing of annulment actions against Higher Committee reports on the basis of administrative decision annulment proceedings, with the rationale that the prohibition on challenging such reports “before any authority” does not extend to judicial authorities.

Establishment of gross medical negligence

Based on the Higher Medical Liability Committee’s findings, the Court confirmed the establishment of gross medical negligence on the part of the first appellant. The Court found that the medical care provided to the patient was inconsistent with recognised medical standards.

Specifically, the negligence consisted of:

• an unjustified departure from established medical principles;
• gross ignorance of accepted medical practices relative to the physician’s level of specialisation;
• insufficient experience in performing that type of surgery; and
• disregard for information contained in the ultrasound report.

These failures resulted in the complete loss of the patient’s stomach function, constituting a permanent disability assessed at 100% of the natural function and capacity of the stomach.

The Court reiterated the established principle that, while a physician is not bound by an obligation to achieve a specific result, the physician’s obligation of care requires the exercise of sincere and vigilant efforts consistent with — save in exceptional circumstances — the established principles of medical science. A physician is liable for any shortcoming in medical conduct that would not be committed by a vigilant physician of the same professional standing placed in the same external circumstances.

Vicarious liability of the medical centre

The Court affirmed several important principles regarding vicarious liability. It held that the relationship of subordination underpinning an employer’s liability for the harmful acts of its subordinate arises whenever the employer exercises actual authority over the subordinate in the form of supervision and direction, even if such supervision is limited to administrative oversight.

The Court further held that a relationship of subordination between a physician and a hospital’s management — even if merely a moral or nominal relationship — is sufficient to impose liability on the hospital for the physician’s errors. This liability is grounded in a presumed fault on the part of the employer, attributable to either a poor choice of subordinate or a failure of supervisory duty, regardless of whether the employer lacks the technical knowledge necessary to supervise the subordinate’s work.

Critically, the Court ruled that even a casual or incidental relationship of subordination is sufficient to establish vicarious liability, provided it is proven that the physician committed an error against the patient during or by reason of the performance of the physician’s duties, or that the position itself afforded the physician the opportunity to commit the error — even where the employer did not in fact exercise supervisory and directional authority over the subordinate at the time of the act.

Applying these principles to the facts, the Court established the liability of the medical centre (the second appellant) on the basis that the first appellant practised as a physician at that centre, where the initial medical examination of the patient was conducted and the decision to perform surgery was taken.

The surgery was performed at the second respondent’s hospital pursuant to an agreement between that hospital and the medical centre. Notably, the terms of that agreement included a clause exempting the hospital from liability for the medical errors of the medical centre’s staff, which the Court took into account in confining liability to the appellants rather than extending it to the hospital.

Assessment of compensation and the Diya/Arsh question

The Court rejected the appellants’ argument that compensation should be capped at the Sharia-prescribed Diya or Arsh. It affirmed that every person has the right to physical integrity, and that any assault resulting in bodily injury constitutes compensable damage, even where it does not impair the injured party’s earning capacity or result in financial losses or treatment expenses.

The Court clarified that physical damage encompasses compensation for both temporary health impairment and permanent partial disability, and that bodily harm necessarily entails physical pain and consequential psychological suffering — constituting the moral damage that warrants separate compensation.

On the critical question of whether the principles of Islamic Sharia (Diya and Arsh) impose a ceiling on compensation, the Court held that the application of Sharia principles is contingent on the absence of applicable statutory provisions in the laws of the Emirate of Dubai. Since Article 292 of the Civil Transactions Law provides for the assessment of compensation on the basis of the actual damage suffered by the injured party, including both loss incurred and profit foregone, the Court ruled that compensation may exceed the value of the Diya or Arsh where the trial court, in the exercise of its discretionary powers, determines that the damage so warrants.

The Court further noted that the patient had not sought compensation on the basis of Arsh under Sharia principles, but had rather confined her claim to compensation for material and moral damages under the Civil Transactions Law. The Court confirmed the autonomy of the trial court in determining the quantum of compensation, holding that the assessment of damage and the determination of adequate compensation are matters of fact within the exclusive competence of the trial court, provided it identifies the elements of damage considered in the calculation and the injured party’s entitlement to compensation for each element.