When the hospital answers for a doctor’s negligence

It is a change in what must be proven for a hospital to be liable. Before, hospital institutions’ liability sat in the strict liability article — answering even without fault. Act 191-2026 moved it to the vicarious liability article, which is answering for another’s fault or negligence. The practical difference is a defence that did not exist before.

Anyone who suffers damages at a health care institution in Puerto Rico and is weighing whom to claim against. The law creates no procedure: it defines when the institution answers and when it does not.

• That the damage was caused by the fault or negligence of someone for whom the institution answers, per the list in the new Article 1540(d). Vicarious liability requires a prior legal nexus between whoever causes the damage and whoever must repair it.Verified against the official source
• That the institution fail to prove it exercised the diligence of a reasonably prudent person. The article itself provides that defence for subsections (a), (b), (c) and (d).Verified against the official source

• The law publishes no document list or form: it is substantive civil law, not a procedure. What decides a case is evidence — the medical record, the physician’s contractual relationship with the institution, who referred the patient — and that is assessed by a lawyer, not a guide.

1. 1

   Step 1: The difference between vicarious and strict, in one sentence

   Strict liability is answering for the damage even where there was no fault or negligence. Vicarious liability is answering for the fault or negligence of another with whom you have a prior legal nexus. Act 191-2026 took health care institutions out of Article 1541, the strict one, and placed them in Article 1540, the vicarious one.

2. 2

   Step 2: The defence the change gives the hospital

   This is what changes most in practice, and it is worth knowing before claiming. Article 1540 closes by saying that “those listed in subsections (a), (b), (c) and (d) are not liable if they prove they exercised the diligence of a reasonably prudent person”. Subsection (d) is the health care institutions one. Under the previous strict liability regime, that defence was not available.

3. 3

   Step 3: Whom the hospital answers for, per the new list

   Subsection (d) lists four groups. One: people who operate exclusive health-service franchises at the institution. Two: the people the institution entrusts to attend a patient who accesses the institution directly. Three: its employees in the exercise of their functions. And four: the negligent acts and omissions of physicians who are its employees; who although not part of its staff are part of the faculty because they are available to attend other physicians’ consults; who perform their functions for concessionaires of exclusive franchises contracted to provide services at the hospital; and who without being employees enjoy privileges at the institution.

4. 4

   Step 4: The private patient exception, which decides many cases

   It is the most important line of the subsection for a family weighing whom to sue, and it is quoted as it stands. On the physician who without being an employee enjoys privileges at the institution, the law adds: “Nevertheless, in these cases, where the malpractice victim is a private patient of the physician with privileges, the hospital answers only for its own negligence and not vicariously.” That is, if you arrived at the hospital because your own physician — who has privileges there but is not an employee — admitted you as their patient, the hospital does not answer for what they do; it answers only for its own. Subsection (d)(2), by contrast, covers the opposite case: when you are the one who accesses the institution directly and it assigns whoever attends you.

5. 5

   Step 5: What left the strict liability article

   Section 2 of the Act repeals Article 1541(g). That article still exists and still imposes liability without fault in the other cases the law reproduces: the keeper, custodian, possessor or user of an animal, for the damages it causes, even if it escapes or strays, ceasing if the damage comes from the victim’s own fault; the person who controls a building or part of it, for damages from objects thrown or falling from it; and the developer, contractor or architect, for damages caused to third parties by a building’s ruin during the ten-year warranty term, by reason of construction, soil or works-direction defects. What left that list was the hospital.

6. 6

   Step 6: What the Legislature said in doing it

   We cite it as what it is — a statement of motives, not operative text — because it explains the change’s scope. The Legislature said that “by this Act it is not intended to free hospital institutions of any liability, but to align the state of the law with the analysis of the legal figures and with existing case law”, and that imposing strict liability on them “is highly onerous and socially imprudent by allowing them to answer without having to prove that fault or negligence intervened in their employees’ actions”. It also mentions that the Supreme Court held in Ríos Ruiz v. Mark, 119 DPR 816 (1987), that neither the federal Food and Drug law nor prevailing doctrine imposes absolute liability on a physician; we did not read that case and do not summarise it.

A damages claim is filed before the Court of First Instance. Act 191-2026 creates no agency, counter or administrative procedure: it is an amendment to the Civil Code. If your claim is about the treatment received rather than about damages, the Patient Advocate Office handles complaints under a different law and has its own guide.

• Believing the hospital always answers for any physician working there: subsection (d) lists the cases, and the private-patient-of-a-privileged-physician exception falls outside vicarious liability.
• Thinking the law eliminated hospital liability: it moved it from strict to vicarious and kept four groups it answers for.
• Ignoring the diligence defence: the institution is not liable if it proves it exercised the diligence of a reasonably prudent person.
• Confusing “accessing the institution directly” with arriving referred by your own physician: subsection (d)(2) covers the patient who accesses directly and whoever the institution entrusts with their care.
• Citing Article 1541(g) to claim against a hospital: that subsection was repealed by this Act.

These are the government pages this guide is based on.

• Poder Judicial de Puerto Rico

  Poder Judicial

  bvirtualogp.pr.gov