In which cases does a delay in emergency health care matter legally?
Failure to provide first aid must be distinguished from late or wrong medical intervention
Failing to place an emergency call for a person who has fallen ill at a hotel, staff with first-aid training not providing appropriate basic assistance, or delaying a necessary ambulance request may essentially create a problem of organization and supervision. The physician’s assessment of the patient and the decision on treatment or referral, by contrast, are examined separately under the standard of professional medical care. Even if both delays contributed to the same outcome, the persons at fault may differ.
Not every serious outcome shows that there was fault
A heart attack, stroke, anaphylaxis, drowning, serious trauma or respiratory failure may end in death or severe damage even with correct intervention. Compensation requires not only a bad outcome but also unlawful conduct attributable to the defendant, damage and an adequate causal link. Against this, the defence that “the person could have died anyway” also cannot be accepted without examining faults that clearly emerge in the care and referral process.
The hotel’s organizational duty regarding guest safety
It cannot be assumed that every hotel has a doctor and an ambulance on permanent standby
No categorical rule such as “every five-star hotel must have its own ambulance” can be established without checking the nature of the facility, the number of staff, the licensing conditions, whether there is a medical unit and any special regulations. However, for a facility that actually provides health services or promises to provide them, the real capacity, staff competence and emergency-call organization are assessed separately.
How reception and security staff handle the first report
When a tourist or a relative reports chest pain, loss of consciousness, shortness of breath or a severe allergic reaction, it must be recorded to whom and when reception passed the call on. Classifying the call as an “ordinary complaint”, not informing the hotel’s medical staff, or having the call passed around between several units may increase the harm.
Contact with 112 and delay in the decision to call an ambulance
When the 112 emergency service was called, which complaint was conveyed, whether the address was given completely and correctly, and whether the operator’s instructions were followed are decisive for emergency health care. It must be investigated on what medical grounds referral in the hotel’s own vehicle was chosen and, if no call was made at all, who made that decision.
The duties of the hotel doctor and of the independent health unit
The physician’s status affects liability
The physician may be a hotel employee, a staff member of an independent health company or a physician called in under a contract. The personal duty of professional care regarding the requirements of medical intervention and the way the hotel organizes its health service are not the same thing. Using a subcontractor does not by itself remove all of the operator’s contractual obligations; however, whether an auxiliary-person relationship was actually established is determined on the evidence.
Law No. 3359, Additional Article 18: permission to investigate a medical act
Additional Article 18 of Law No. 3359 on Basic Health Services provides a special permission procedure in criminal investigations concerning medical acts relating to examination, diagnosis and treatment carried out within the practice of the health profession by health professionals working in public or private health institutions and organizations within its scope. Permission to investigate is given by the Professional Responsibility Board (Mesleki Sorumluluk Kurulu) within the authority set out in the law; a separate regime is reserved for persons covered by Article 53 of the Higher Education Law. It cannot be accepted that every doctor working at a hotel automatically falls within this scope. The doctor’s legal status, the licensed health institution with which the doctor works and whether the act complained of is a medical act or an organizational failing of the hotel are determined separately. Conduct that is not a medical act, such as the hotel operator’s failure to call an ambulance, must not be confused with this special permission procedure.
The physician’s initial assessment and the decision to refer
In a life-threatening situation, the history taken, vital signs, clinical suspicion, an ECG where necessary and the decision on emergency transfer are compared with the medical standard appropriate to the circumstances of the incident. If a decision was made to wait and observe, its basis and the risk explained to the patient’s relatives should be recorded. Just as not every physician can be expected to have equipment at every level of specialization, delay in referring a situation that exceeds the available means to an appropriate centre cannot be overlooked either.
Related article: Delayed Care in the Emergency Department and Wrongful Discharge: Physician and Hospital Liability for Compensation.
Information and the patient’s refusal of transfer
The patient may have refused medical care or referral. However, the refusal must be conscious, based on adequate information and documented. Where the medical condition is serious, there is impaired consciousness or a language barrier, the validity of the declaration of refusal is examined separately. A single signature on a document does not remove all of the physician’s obligations.
How is the timeline built in emergencies?
The time between the first symptom and the first call
The accounts of the patient, relatives, other guests and staff on the start of the incident are compared with room-phone records, messages, emergency calls and camera times. The time established must be assessed together with the nature of the symptoms and the medical course of the illness.
From the moment reception gave notice to the moment health staff arrived
Operation logbooks, internal phone records, shift lists, call records of the hotel doctor and door/entry logs may show this interval. Because the incident times may differ from one another by a few minutes owing to device clocks, the source systems should be calibrated against each other.
The 112 call, the departure of the ambulance and arrival at the hospital
The 112 call recording and incident number, the ambulance dispatch record, arrival and departure times, the patient handover form, and the emergency department triage and first-intervention record are examined together. The expert must be given not only the hospital discharge summary (epikriz) but the entire timeline.
Treatment abroad and autopsy data
If the foreign tourist later receives treatment in their home country, suffers complications or dies, the foreign medical records, the cause of death and any possible connection with the delay in Türkiye are assessed separately. Translation and, where necessary, official verification support the evidentiary weight.
Causation between the delay in intervention and the damage to health
“If they had gone earlier, they would certainly have survived” is not a mandatory standard of proof
Medical assessment often works with probabilities. In every case, the expected effect of appropriate intervention, the preventability of the poor outcome and the contribution of the delay to the result are examined separately. Just as demanding that every possibility be established with certainty may be practically impossible, it is equally wrong to derive liability automatically from mere probability.
The existing illness must be separated from the increase in harm
The illness itself may not have been caused by the operator’s conduct. Even so, the delay may have increased permanent neurological damage or reduced the chance of recovery. The damage subject to compensation can be determined by technically separating the initial illness from the increase that can later be attributed to the delay.
The alternative course of events: what would have happened if an ambulance had been called?
The medical expert must discuss the distance of the scene, the real response capacity of 112, the clinical guidelines of the relevant period and the consequences of the transfer method chosen. An abstract statement such as “if there had been an ambulance, the death would not have occurred” is not sufficient; on the other hand, why referral by private vehicle was chosen instead of an ambulance cannot be left without reasons.
The Court of Cassation, 13th Civil Chamber, decision on a hotel doctor and an ambulance
Court of Cassation, 13th Civil Chamber (Yargıtay 13. Hukuk Dairesi), E.2016/20933, K.2018/4147, T.04.04.2018
The decision examined a compensation action brought by the relatives of a foreign tourist who fell ill at night in a hotel and died. The claimant side alleged that they asked hotel reception for emergency help and an ambulance, that a physician came, but that the patient was taken to hospital by car rather than by ambulance. The report of the expert panel made up of a tourism specialist, an occupational-safety specialist and a cardiologist and the report of the Council of Forensic Medicine (Adli Tıp Kurumu) reached different conclusions.
The main ground for reversal is not a definitive finding of fault
The Court of Cassation reversed the judgment dismissing the claim on the grounds that the contradiction between the reports was not resolved, that the fault attributed to the hotel operator was not separately clarified and that no verifiable report was obtained. It cannot be concluded from the decision that “the hotel and the physician are definitely at fault” or that “referral without an ambulance is in every case the sole cause of death.” That the fault of the hotel and the fault of the physician must be investigated separately, with an expert panel, in the concrete case is the strong principle that can be drawn from the decision.
Which evidence does this decision bring to the fore in a similar case?
When the complaint was reported, the physician’s medical assessment, the choice of transport vehicle, the ambulance request, whether the patient was made to walk, the time of arrival at the hospital and the disagreement among the experts should be investigated together. It offers the claimant an opportunity to make the delay concrete, and the defendant an opportunity to demonstrate medical care and alternative causation possibilities.
Public ambulance service and the private hotel’s liability fall under different judicial paths
Council of State, 10th Chamber (Danıştay 10. Daire), E.2023/691, K.2024/1025, T.21.03.2024
This decision addressed the allegation that no ambulance was sent despite a 112 call and that the patient lost his or her life. The administration’s service fault, the causal link with the death and the relatives’ non-pecuniary damage were assessed separately. The decision concerns the examination of an allegation against the public emergency service, not the contractual liability of a private hotel for its physician. The administrative and ordinary judicial regimes must not be treated as the same.
For what purpose and in which action are 112 records used?
In a compensation action against a private hotel or physician, the 112 records show the course of the incident over time. If a fault of the public ambulance service is alleged, the conditions of the application to the administration and of the full remedy action are examined separately; the scope of claims directed at different institutions for the same violation and the bar on double recovery must be assessed.
Article 13 of the İYUK in the case of a deficiency in the public 112 service: application to the administration and time limit
Where a service fault is alleged from the operation of the public 112 ambulance service and the conditions of an administrative act are met, the rule requiring an application to the relevant administration is assessed under Article 13 of Administrative Procedure Law No. 2577 (İYUK): within one year of learning of the act and, in any event, within five years of the date of the act. A full remedy action may be brought within the applicable time limit running from the day after notification of the partial or complete rejection of the application or, where no reply is given within thirty days, from the expiry of that period. Unless there is a special provision, the general time limit for bringing an administrative action is sixty days under Article 7 of the İYUK. The date of learning, the violation of the public service, the emergence of the damage and the nature of the particular incident may affect when the time limit starts. These time limits cannot be transferred directly to an ordinary-court action against a private hotel or a private physician.
Related article: Doctor Error at a Public Hospital: Administrative Application and Full Remedy Action.
Possible legal liability of the hotel, the physician and the health company
The hotel’s contractual liability
An operator providing accommodation services has an obligation to look after the guest’s physical safety and to run its emergency organization reasonably. Articles 112 and 116 of the Code of Obligations (TBK) may serve as a basis, depending on the concrete circumstances of the accommodation relationship. These provisions do not show that every hotel guarantees a definite treatment result.
The health professional’s duty of professional care
It is examined whether the physician carried out the assessment and referral in accordance with the accepted requirements of medical science. In assessing medical fault, the knowledge and means available on the date of the incident are the basis. A medical standard that develops later is not automatically applied to an earlier incident.
The liability of an independent health institution
If the health service is provided by an independent institution outside the hotel, the chain of contract, patient admission, assignment and intervention is investigated. The competent court and mandatory mediation are determined by the contractual relationship and by who the proper defendant is.
Compulsory financial liability insurance for medical malpractice
In a liability claim arising from a health professional’s own medical intervention, it must be examined whether compulsory financial liability insurance for medical malpractice (Tıbbi Kötü Uygulamaya İlişkin Zorunlu Mali Sorumluluk Sigortası) exists, within the framework of the professional capacity, the policy period, the scope of cover and the exclusions. This policy is not identical to the hotel’s general operating liability insurance or to the cover of a separate ambulance/health company, if there is one. The physician’s fault in the referral decision and institutional failings such as reception not calling an ambulance may give rise to different grounds of liability and different insurance relationships.
Related article: Medical Malpractice Insurance: Coverage, Claims to the Insurer and Compensation.
The injured person’s own conduct
Late reporting of the complaint, refusal by the patient of a recommended referral or risky behaviour may be assessed under Article 52 of the TBK. They should not be made the basis of a reduction unless their effect on causation is proved.
Compensation in cases of death, permanent disability and an interrupted holiday
Heads of bodily damage
Under Article 54 of the TBK, treatment, care, temporary incapacity for work, permanent loss of working capacity and impairment of economic future may be assessed together with costs of return to the home country or transfer in the concrete case. The legal nature of payments received from insurance and whether they are subject to recourse must be investigated separately.
Claims of relatives in the case of death
Under Article 53 of the TBK, reasonable funeral expenses, treatment and loss of earnings before death and loss of support may arise; under Article 56 of the TBK, the relatives’ claims for non-pecuniary damages may arise. The claim and the relationship of support must be proved separately for each relative.
Related article: The Rights of the Relatives of a Foreign Tourist Who Dies on Holiday in Türkiye: Judicial Procedures, Repatriation of the Body and Compensation.
The amendment to Article 55 of the TBK after 31 July 2026
The provisions added to Article 55 of the TBK by Law No. 7589 distinguish the start of interest for periods in which the income is known and not known and regulate the proportional set-off of payments made for compensation up to a certain stage. Under the transitional provision, they apply to relevant damage-causing events on or after 31.07.2026; they cannot be applied mechanically to events that took place earlier. The specific head of compensation and the scope of the applicable interest must be examined separately.
The start of interest and the interest rate are not the same legal question
The amendment to Article 55 of the TBK by Law No. 7589 regulates, only for loss of working capacity and loss of support damages within its scope, the start of interest by reference to the periods in which the income is known or not known, and the set-off of certain advance payments. By contrast, Law No. 3095 concerns separate matters such as the statutory interest rate to be applied and interest on foreign-currency debts. In a claim, the start of interest, the currency, the type of interest and the period must be justified independently of one another.
Article 1 of Law No. 3095: variable statutory interest from 31 July 2026
Article 1 of Law No. 3095, as amended by Article 10 of Law No. 7589, takes as its basis, for statutory interest not fixed by contract, 80% of the rediscount rate for short-term credit transactions of the Central Bank of the Republic of Türkiye (TCMB) dated 31 December of the previous year. If the 30 June rate differs by five points or more from the previous 31 December rate, 80% of the 30 June rate applies for the second half of the year. The interest rate is not fixed and is not the same for all years; it must be calculated with the relevant date range and the provisions on entry into force and transition. The percentages here are not the current interest rate to be applied in a concrete file but the statutory calculation method.
Article 4/a of Law No. 3095 on foreign-currency claims and the currency of the judgment
Whether compensation can be claimed and awarded in foreign currency is determined separately according to the head of damage, the nature of the debt, the applicable law and the relief sought. In a claim characterized as a foreign-currency debt, Article 4/a of Law No. 3095 takes as its basis, unless a higher rate of interest was agreed in the contract, the highest interest rate that state banks pay on one-year deposits opened in that currency. That an invoice issued abroad is drawn up in euros does not by itself mean that the compensation awarded will be in euros. First the currency of the claim must be determined, then the interest regime applicable to it.
Which documents should be preserved after an emergency health incident?
Hotel and call records
The hotel’s call-centre records, reception’s internal phone records, the doctor call log, camera footage, the security report, the incident report and the shift list should be preserved together.
Medical records
The first examination note, vital signs, ECG, prescription, referral recommendation, 112 records, ambulance patient-handover records and hospital admission records should be obtained. As far as possible, traces of later corrections to electronic records should be preserved.
Autopsy and examination of the cause of death
In the event of death, besides the death certificate, if the death is suspicious or a forensic one, the scope of the autopsy and forensic medical examination conducted by the public prosecutor’s office is important. The clinical diagnosis and the forensic cause of death are not always the same document.
Foreign medical records and income documents
Information on rehabilitation, loss of working capacity or death after the tourist returns to their home country may be submitted to the Turkish file with appropriate translation and verification. Actual income and social security payments are examined in the compensation calculation on the basis of the relevant currency and calculation period.
Jurisdiction, time limits for applications and preservation of evidence
Distinguishing private health service, consumer matters and administrative acts
Whether the dispute arises from the accommodation contract, from medical service or from the public ambulance service is a critical distinction for jurisdiction and procedure. Consumer proceedings, a general tort action, an insurance claim or an administrative full remedy action are not subject to the same time limits and conditions.
Preservation of evidence
HMK Article 400 et seq. may be considered before the action is filed for camera/recording and technical evidence that may be lost. A request for preservation of evidence does not in itself suspend the time limit for filing an action or for an administrative application.
Private international law
MÖHUK Article 34 on tort and the relevant contract provisions are important for the law applicable to accommodation and health services. The exceptions in MÖHUK Article 26, the international jurisdiction regime in Article 40 et seq. and, for a foreign claimant, the security under Article 48 must be addressed in the specific case.
Partial Action, Increase of the Claim and Limitation in Compensation Actions After 2026
The repeal of HMK Article 107 and the protection of actions filed earlier
Article 19 of Law No. 7589 repealed HMK Article 107, which regulated the action for an undetermined claim, as of 31 July 2026. However, paragraph ten of Provisional Article 1 of the Law expressly provides that the repealed Article 107 will continue to apply to actions filed before its repeal. An earlier action for an undetermined claim therefore cannot be treated as invalid merely because the provision was later repealed. The legal characterization of new actions and the increase of the claim in pending files must be determined by considering the filing date of the action together with the transitional provision.
HMK Article 109(4): a one-time increase of the claim in a partial action
The fourth paragraph added to HMK Article 109 by Article 20 of Law No. 7589 provides that, where part of a claim is sued for, the subject matter of the claim may be increased once only in the same action, until the end of the investigation phase (tahkikat), without being subject to the prohibition on expanding the claim. The Law provides that, for the part increased in this way, limitation is deemed interrupted from the date of the action. The scope and timing of the increase and its relationship to court fees and to the relief sought must be checked separately in the specific file; unlimited or repeated increases cannot be made on the basis of the same rule.
Limitation, type of action and head of compensation must be examined together
For tort, TBK Article 72 must be kept separate from the special or general periods applicable to claims arising from a contract or an insurance relationship. The new HMK Article 109(4) is not a provision that generally extends all limitation periods. For pecuniary and non-pecuniary damages, treatment/incapacity for work, loss of support, insurance claims and the different claims to be directed against the other side, the type of action, the relief sought and the calculation of time limits must be framed together. A criminal investigation, preservation of evidence or a request for talks does not by itself suspend statutory time limits.
Conclusion
Liability arising from a delay in emergency care on holiday cannot be resolved merely by asking whether the health worker came. The first report, the doctor’s assessment, the 112 call, the means of referral, arrival at the hospital and the treatment results must be combined into a single timeline. If reports conflict on medical fault and causation, they should be resolved by a reasoned expert examination. The hotel’s organizational fault, the physician’s medical care and the liability of the public emergency service must be kept as separate legal heads.
Frequently Asked Questions
Must a hotel provide a private ambulance for every guest who falls ill?
No general rule of that kind can be established for every facility. However, the emergency call and an appropriate referral organization must be carried out in practice and with reasonable care.
If the hotel doctor examined the patient, is the operator not liable at all?
No. How the health service was organized and any delays in the call and referral process may be assessed separately.
Is being taken by car instead of an ambulance automatically a fault?
Not in every case. The patient’s clinical condition, the urgency of the transfer and the medical necessity are determined by expert examination.
Which record is the most important in the timeline?
There is no single record. What matters is the consistency of the first report, the 112 call, the doctor’s arrival time, the referral and the hospital admission records with one another.
Did the Court of Cassation’s hotel-doctor decision award definite compensation?
No. The decision, E.2016/20933, K.2018/4147, is a reversal made because of contradictory reports and an incomplete examination.
Does a patient’s earlier heart condition end the claims?
No. The course of the initial illness and any increase in harm attributable to the delay are examined separately.
If 112 did not send an ambulance, is the action brought against the private hotel?
The liability regime changes according to who breached the obligation. The administrative-court route must be assessed separately for the public service.
Can foreign hospital documents be used after the tourist returns home?
Yes. The nature of the documents, their translation, the need for official verification and the competent medical examination of the disability are dealt with separately.
Is it necessary to wait for the criminal investigation to end before seeking a remedy?
In general, not in every case. However, the processes should be planned together according to the state of the evidence and of limitation.
Is the permission of the Professional Responsibility Board (Mesleki Sorumluluk Kurulu) required in every case for a criminal investigation of a hotel doctor?
No. The personal and material scope of Additional Article 18 of Law No. 3359 must be examined. The doctor’s relationship with a licensed health institution and whether the allegation concerns a medical act are decisive.
Are the 112 failure to send an ambulance and the hotel’s delay in the call examined in the same action?
Not in every case. For an allegation of a public service fault, Article 13 of the İYUK and the administrative courts apply; for a fault of a private hotel or of health service, the relevant ordinary-court regime is assessed separately.
How is the claim increased in pecuniary compensation actions filed in 2026?
On 31 July 2026 HMK Article 107 was repealed; HMK Article 109(4) regulated a one-time increase in a partial action before the end of the investigation phase. The transitional provisions apply to earlier action records.
Sources and legal bases
- Law No. 6098, Turkish Code of Obligations (Türk Borçlar Kanunu), Articles 53–56, 66, 72, 74, 112 and 116; the amendments to Article 55 introduced by Law No. 7589. resmigazete.gov.tr
- Law No. 6502 on Consumer Protection (Tüketicinin Korunması Hakkında Kanun) and the applicable conditions for bringing an action.
- Law No. 5718 on Private International Law and International Civil Procedure (Milletlerarası Özel Hukuk ve Usul Hukuku Hakkında Kanun), Articles 26, 34, 40, 45, 48.
- Ministry of Health, regulations on emergency health services and on ambulances and emergency health vehicles. mevzuat.gov.tr
- Law No. 6100, Code of Civil Procedure (Hukuk Muhakemeleri Kanunu), Article 400 et seq.
- Law No. 3359 on Basic Health Services (Sağlık Hizmetleri Temel Kanunu), Additional Article 18 (Professional Responsibility Board). shgmmevzuatdb.saglik.gov.tr
- Law No. 2577, Administrative Procedure Law (İdari Yargılama Usulü Kanunu), Articles 7 and 13. mevzuat.gov.tr
- Law No. 7589, amendments to HMK Articles 107 and 109(4); Law No. 3095, Articles 1 and 4/a. resmigazete.gov.tr
- General Conditions of Compulsory Financial Liability Insurance for Medical Malpractice (Tıbbi Kötü Uygulamaya İlişkin Zorunlu Mali Sorumluluk Sigortası Genel Şartları) (assessed together with the relevant policy and the date of the incident). mevzuat.gov.tr
- Court of Cassation, 13th Civil Chamber (Yargıtay 13. Hukuk Dairesi), E.2016/20933, K.2018/4147, T.04.04.2018 (hotel doctor, ambulance and contradictory expert reports; reversal). ictihatlar.com.tr
- Council of State, 10th Chamber (Danıştay 10. Daire), E.2023/691, K.2024/1025, T.21.03.2024 (112 ambulance service and the administration’s liability). app.dejure.ai