How to sue IMSS for medical malpractice?

Table of content

Tiempo de lectura: 4 minutos

Although the institution would like to deny it, most Mexicans are aware of the bad practices that are commonly performed at the Mexican Social Security Institute (IMSS), either because they have suffered mistreatment themselves or because family members or friends have been the victims. Medical malpractice has many faces, if we are fortunate enough not to need public health services and have never suffered from negligence by doctors or other health professionals, we will surely have heard or read several cases, which seem like horror stories, that are not solved or are solved until several years later.

What is medical malpractice in IMSS?

Medical malpractice in IMSS refers to the lack of proper care by health personnel, which causes harm or damage to the patient. Some examples range from misdiagnosis, contraindicated medications, to amputation of limbs, disabling injuries or death.

A few years ago the Supreme Court of Justice of the Nation issued a ruling that established the guidelines to establish the reparation of damages caused by malpractice in the exercise of health services provided by the IMSS; an affected person has the right to the following legal actions:

Suit against the IMSS for the corresponding patrimonial responsibility; that is to say, it is possible to claim payment for the physical and moral damages, as well as the payment of the necessary expenses so that the affected patient (in case he/she has not died) receives the necessary treatment until he/she heals, or for life if the sequels merit it.
Criminal lawsuit against the doctor who incurred in malpractice.
Civil lawsuit against both the IMSS and the doctor who committed the malpractice, demanding the payment of physical and moral damages.

Malpractice has consequences that range from a wrong diagnosis, contraindicated medications, to amputation of limbs, disabling damage to the patient or death; even though the IMSS has tried to hide or cover up these cases, they are known and happen more frequently than we imagine. When going through a situation like this, it is possible to file an administrative complaint for the IMSS to punish the doctor by means of a reprimand, fine or dismissal; however, very few times this happens, either because it is not known where to sue the IMSS or for other reasons, so it is recommended to seek advice through institutions such as Conamed or directly with lawyers for a faster and more satisfactory resolution.

What are the requirements to sue IMSS?

Before suing IMSS, the patient must ensure that he/she meets the following requirements:

Statement of facts. The affected patient or his/her relatives must make a statement to describe the facts to be reported.
Complain to the corresponding authority. First, the complaint must be filed at the family medical unit or hospital where the injury occurred. Subsequently, the complaint should be filed with the Employer Audit Department of the IMSS Subdelegation closest to your home. If the IMSS investigation proves the fault, an administrative liability process will be followed in order for the IMSS to punish the doctor by means of a reprimand, fine or dismissal. However, this rarely happens.
Go to the Conamed. If the IMSS does not respond, the next step is to go to the National Medical Arbitration Commission, a decentralized public body that offers a free conciliation and arbitration service in cases of medical malpractice.
File a lawsuit. If a favorable response is not obtained through the Conamed, it will be necessary to file a lawsuit.

What are the steps to file a claim against the IMSS?

Step 1. Hire a Medical Malpractice Lawyer

Medical malpractice cases are very complex, so you need a multidisciplinary team to represent you and help you obtain redress.

Step 2. Filing a medical malpractice lawsuit

Your lawyer will draft the claim and file it through the appropriate avenue, which may be:

Civil liability. In case the injury or damage has caused injury or moral damage, a lawsuit is filed before civil courts to obtain compensation.
Patrimonial liability. This type of lawsuit is filed when the negligence was not caused by the medical staff, but by the institution for inefficient provision of public services.
Criminal liability. A criminal lawsuit is filed in extreme cases to disqualify, fine or imprison the person responsible for malpractice. For example, in the case of a health professional who realizes that he or she has caused harm to a patient and does not attempt to remedy it, or who acts premeditatedly to cause harm to the patient.

Step 3. Attend hearings

Attend the hearings requested by the court on time and follow up the case through your attorney, who will represent you, advise you and recommend the best legal actions, such as a negotiation with the opposing party.

What evidence is needed for a medical malpractice claim?

Be an IMSS beneficiary. The affected person must be affiliated with the institute, have his or her social security number (NSS) and the necessary documentation to prove that the injury or damage caused was the result of medical care in a family unit or hospital.
Medical record. The patient’s medical record, which includes medical history, results of blood or imaging studies, prescriptions and all documentation.
Expert opinion. In most cases, an impartial medical expert’s opinion is required to certify that you suffered medical malpractice.
Testimonials. Witness testimony, which may be your family members or other health professionals who can corroborate the malpractice.

How long do I have to sue IMSS?

The time you have to sue the IMSS is a maximum period of two years, although depending on the legislation of the states, they allow a variation of between one and five years for you to file the lawsuit.
Ideally, you should file your claim as soon as possible to ensure that your case is heard, and you receive the justice you deserve.

Where can I sue IMSS?

If you need to file a complaint for irregularities committed by IMSS service providers in the performance of their duties, you can contact the IMSS Internal Control Organ at 01 800 623 2323 option 6, from 09:00 to 17:00 hours, working days from Monday to Friday. It is very important not to let cases of negligence go unpunished, since both physicians and institutions must know that these behaviors will not be tolerated and may cause personnel to lose their jobs, go to jail and pay for the reparation of damages caused by their bad practices.

In Lex & Co we are expert lawyers in medical malpractice, we have a team of specialists to provide a better service; if you or someone close to you has been a victim of these institutions, call us and tell us your case.

Get More Information

Lic. Carlos Figueroa Rodríguez

Carlos Figueroa Rodríguez, attorney at law at Lex & Co. He has more than 10 years of experience in specialized cases involving medical malpractice and insurance claims. He is a graduate of the Universidad Anáhuac and has a Master’s Degree in Constitutional Law and Amparo from the National Bar Association. He also has a Doctorate in Juridical Sciences from the UCI Mexico. Professional license 6577215.