Termination of Contract and Professional Liability: Commentary on Judgment Cass. civ., Section III, no. 16919/2018

The judgment of the Court of Cassation no. 16919 of June 27, 2018 offers important food for thought on the liability of healthcare professionals and the interpretation of damage for loss of chance. In this case, the relatives of a patient who died due to a heart attack sought compensation for damages due to a diagnostic omission by a doctor. The Court upheld the appeal, highlighting how an omission can constitute compensable damage, even if the patient's life would have been limited in time.

Context of the Judgment

In the case at hand, patient S. had gone to the emergency room for retrosternal pain, receiving an incorrect diagnosis. Only later, due to the worsening of his condition, was a heart attack diagnosed. The relatives, believing that the doctor's negligence had caused their loved one's death, initiated legal action to obtain compensation. The Court of Appeal of Cagliari, however, had initially rejected the claim, arguing that timely intervention would not have changed the fatal outcome.

The omission of the diagnosis of a terminal morbid process determines the existence of compensable damage to the person, where it is found that, as a result of the omission, the patient lost the possibility of survival for some weeks or some months, or in any case for a limited period, longer than the period actually lived.

Analysis of Damage for Loss of Chance

The Court of Cassation reiterated a fundamental principle: a diagnostic omission can lead to compensable damage, even if the patient had a limited probability of survival. In fact, the doctor's error deprived the patient of the possibility of living for a period, however brief, longer. This view is in line with the principle of case law that considers the loss of chance as damage in itself, distinct from the mere possibility of a better outcome. In this regard, the Court referred to previous judgments (Cass. September 18, 2008, no. 23846) which stated that the loss of chance is to be understood as a damaging event, not as an uncertain future expectation.

• The causal link must be examined in relation to the loss of survival.
• The doctor's liability is not limited to mere diagnosis but extends to the patient's quality of life.
• Damage for loss of chance must be quantified in terms of time and quality of life.

Conclusions

The Cassation judgment no. 16919/2018 represents an important step forward in protecting the rights of patients and their relatives. It clarifies that professional liability is not limited to the patient's death but can also extend to the loss of periods of life, however brief. The Court reiterated the need to assess the healthcare professional's conduct not only in relation to the final outcome but also in relation to the immediate and future consequences of their omission. This approach could have a significant impact on future medical-legal disputes, reinforcing the need for adequate and timely diagnosis.