Puisque 20 % des Canadiens déclarent avoir une autre langue maternelle que le français ou l\'anglais, il n\'est pas rare que les professionnels de la santé et les patients maîtrisent des langues différentes. Lorsqu\'un médecin et son patient ne peuvent pas communiquer correctement, ils courent le risque de mal se comprendre, ce qui peut se solder par de mauvais résultats cliniques et une réadmission hospitalière. Les services d\'interprétation professionnels sont associés à une amélioration de la communication, de l\'utilisation des soins, des résultats cliniques et de la satisfaction envers les soins. Il est démontré que le recours à des interprètes non formés ou improvisés, y compris les membres de la famille, accroît les erreurs d\'omission, les substitutions, les modifications volontaires et les ajouts. Les enfants et les adolescents n\'ont pas acquis une maturité développementale suffisante pour agir en qualité d\'interprètes dans le milieu de la santé. Dans un tel contexte, ils sont mis dans une situation inappropriée avec laquelle il peut être difficile de composer et qui peut compromettre durablement à la fois leur propre santé mentale et leur relation avec les autres membres de la famille.

The concept of medical error in responsibility litigation was based until the past last years on a necessary direct and definite causal link between fault and injury. In France, since the 1960s and increasingly during the last decade, the idea of loss of chance arose, considered as a new and genuine prejudice (practically, a fixable damage); it became the subject of several legal precedents from the Cour de cassation and the Conseil d\'État. Thus, plaintiffs may currently demand a compensation for a loss of chance even though a doubt exists on the causal link between the fault and the observed damage. The most frequent litigation circumstances implying a loss of chance are lack of information, lack or delay in diagnosis, delay in action, and default in medical assessment. Based on practical cases, the author presents the most propitious situations where litigation for loss of chance may occur and discusses possible preventive measures.

The medico-legal risk specifically associated with the practice of ambulatory surgery is still not well studied. SHAM insurances are the biggest French provider of medical liability insurances. The study of the insurance claims provided by this insurer is therefore a relevant source of data on the complications related to ambulatory surgery.
OBJECTIVE: The aim of this study was to compare the claim rate related to ambulatory surgery with non-ambulatory surgery.
METHODS: We did a retrospective study on insurance claims provided by SHAM insurances between 2007 and 2011 to compare the claim rate related to ambulatory surgery with non-ambulatory surgery.
METHODS: We searched the files in the SHAM database, and then analyzed them.
RESULTS: On the study period, out of a total of 29565 registered claims, 467 (1.6%) originated from ambulatory surgery. On the total of 29,098 registered claims for non-ambulatory surgery, 2151 (7.4%) led to a condemnation whereas the rate was 7% (33 out of 467 claims) for ambulatory surgery. The condemnations linked to ambulatory surgery amounted to 1.5% of the total (33 out of 2184), for a cost of 1.7 M€ (versus 400,3 M€ for non-ambulatory surgery). The average cost of a compensation is therefore 50,500 € for ambulatory surgery and 186,000 € for non-ambulatory surgery. The medical specialties concerned are primarily ophthalmology, abdominal and orthopedics surgery. The main identified causes were medical errors (n=16) and nosocomial infections (n=13).
CONCLUSIONS: The claim rate in ambulatory surgery is proportionally less frequent with compensations three times less and were related to the most frequent type of surgery done in ambulatory settings. These data should help strengthen quality approach in ambulatory surgery.