The Cnam was convicted in Strasbourg on Thursday of manslaughter following the 2023 suicide of an "overwhelmed" medical advisor, a tragedy that casts a harsh light on a "delicate" profession.
The Strasbourg judicial court followed the prosecutor's recommendations, who had requested a fine of 50,000 euros for the National Health Insurance Fund during a hearing in early October.
On December 12, 2023, Dr. Catherine Dumas-Pierog, 44, jumped out of a window from the 3rd floor of the health insurance offices in Strasbourg, a few hours after receiving her schedule for the following month.
In a report sent to the public prosecutor in October 2024, the Labour Inspectorate considered that the doctor, hired in May 2023 at the local branch of the Bas-Rhin medical service, had been the victim of manslaughter by her employer.
"I can't improve, I can't integrate, I can't take it anymore, I'm breaking down, I beg your forgiveness," she wrote in a handwritten note left on her desk, according to the report from the Labor Inspectorate obtained by AFP.
"According to the study of her email inbox, the victim frequently sent emails very early in the morning (the earliest recorded at 05:32 AM)," according to the same document.
– Death threats –
With this judgment, "the court recognizes that the Cnam was responsible for not having sufficiently looked after the psychosocial well-being" of an employee, commented Me Laurent Paté, lawyer for the CFDT Federation of social protection, civil party in the trial, to AFP.
In this context, the judgment "is an important decision because there is relatively little case law in this type of case," he noted, even though in the 2000s the suicide cases at France Télécom (now Orange) "made headlines" and illustrated the problem of moral harassment.
Social Security medical advisors carry out "a delicate mission," recalls lawyer Paté: they are notably responsible for verifying the validity of sick leave and recognizing cases of occupational illness. They are sometimes subjected to physical or verbal abuse from insured individuals.
"The victim had been the target of death threats in June 2024," according to labor inspectors.
– Door closed –
The report from the Labour Inspectorate noted that following a reorganization in 2019 and the implementation of new software, Dr Dumas-Pierog found herself "overwhelmed by her work".
His suicide "cannot be considered a local and isolated act," denounced the Labour Inspectorate, referring to a "suicide attempt by a manager" in the Parisian services of the Social Security and an alert to suffering at work in Brittany.
The reorganization, dubbed "Smmop" for "Medical Service Management Organization Performance", was the subject in 2021 of an alert regarding psychosocial risks established by occupational medicine, which mentioned "suffering at work for many employees caused by vertical management".
Regarding Dr. Dumas-Pierog, his superiors had been alerted two weeks before he committed the act, according to the same source.
The victim, who had already worked in this profession between 2008 and 2016, "found herself in conflict between the pressure of objectives to be achieved and a lack of autonomy in her management" induced by the reorganization of the work of medical advisors.
The labor inspectors noted that these individuals "no longer have control over the management of medical records (...) As soon as one record is processed, another takes its place."
Contacts between colleagues "are mainly made by email," according to the report, which notes that the victim had not participated in meals with colleagues for several weeks "and was closing the door of her office."
When contacted by AFP, the Cnam had not reacted to this information by Thursday evening.
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