Healthcare Professional Liability: Commentary on Judgment No. 5808 of 2023 of the Court of Cassation

The recent judgment No. 5808 of 2023 by the Court of Cassation has addressed a matter of significant importance in the field of healthcare professional liability, particularly concerning the occurrence of hospital-acquired infections. This ruling offers significant insights into the liability of healthcare facilities and the burden of proof that rests on the parties involved.

The Case and the Court of Appeal's Decision

The case began when A.A. underwent surgery on his femur, which resulted in disabling outcomes due to an infection contracted in the hospital. The Court of Appeal of Palermo granted A.A.'s claim for damages, ordering the hospital company to compensate for biological damage amounting to 152,000 euros. The healthcare facility subsequently appealed to the Court of Cassation, disputing liability for the infection's occurrence.

Legal Principles Affirmed by the Court of Cassation

The Court of Cassation upheld the Court of Appeal's decision, emphasizing that it is incumbent upon the healthcare facility to demonstrate compliance with sterilization and disinfection obligations. Specifically, the Court affirmed:

• The patient has the burden of proving the causal link between the worsening of their condition and the actions or omissions of healthcare professionals.
• If the patient fulfills this burden, the facility must demonstrate that the harmful event was caused by an unforeseeable and unavoidable impediment.
• An infection, while it may have a certain probability of occurring even with proper adherence to regulations, does not exclude the facility's liability if it fails to prove that all necessary precautions were taken.

The Court reiterated that the responsibility to ensure and the burden of proving the diligent sterilization of the hospital environment rested with the healthcare facility.

Conclusion

Judgment No. 5808 of 2023 represents an important confirmation of liability principles in the healthcare sector. It clarifies that, despite the not always predictable nature of hospital-acquired infections, healthcare facilities must always demonstrate that they have implemented the necessary measures to prevent such events. This decision not only helps protect patients' rights but also reinforces the duty of healthcare facilities to ensure safe and quality service.