Administrative Responsibility of Hospitals for SOP Violations in Maternal Referrals by Independent Practicing Midwives

Hospitals receiving emergency maternal referrals from independent practicing midwives are expected to provide prompt care based on clinical need. In practice, document verification, delayed triage, and transfers due to limited capacity can interrupt care and raise questions about hospitals’ administrative responsibility. This study identifies hospitals’ legal duties in receiving and managing maternal referrals, examines when violations of standard operating procedures (SOPs) give rise to administrative responsibility, and determines the legal basis for sanctions. It employs doctrinal legal research with statutory and conceptual approaches, applying grammatical and systematic interpretation to three analytical scenarios. The analysis finds that administrative responsibility arises when an act or omission attributable to the hospital breaches a legal duty. SOPs serve both as benchmarks for evaluating practice and as objects of review when their design delays emergency care. The study proposes a four-stage framework for identifying when a legal duty arises, assessing the hospital’s response in light of the information and capacity available at the time, determining whether the breach is attributable to the institution, and establishing the legal basis, competent authority, and conditions for administrative sanctions.